Intestinal bacteria in patients with tropical sprue.

Ten samples of jejunal fluid from patients with tropical sprue and 11 from controls without this disease were examined bacteriologically, using techniques designed to obtain the optimal yield of aerobic and anaerobic bacteria. Total colony counts did not differ significantly in the two groups studied. The organisms isolated comprised a wide range of aerobic and anaerobic bacteria.

Multifactorial megaloblastic anaemia.

Ninety-five patients who had megaloblastic anaemia, and who lived in a subtropical climate, were studied to elucidate the importance of puerperium, malabsorption, gastric dystrophy, diet and infection in the aetiology of the disease. All 5 factors were found to be common, and to occur in a variety of combinations, producing a wide spectrum of illness variously resembling nutritional megaloblastic anaemia, sprue, pernicious anaemia and many stages in between. It is concluded that megaloblastic anaemia in this population is a multifactorial disease, and a tentative scheme, relating the aetiological factors, is drawn up.

Depressed cell-mediated immunity in megaloblastic anemia due to folic acid deficiency.

Cell-mediated immunity has been studied in patients with 1) megaloblastic anemia of folic acid deficiency, 2)megaloblastic anemia of pregnancy, or 3) iron-deficiency anemia. Using dinitrochlorobenzene skin tests, phytohemagglutinin-stimulated lymphocyte transformation, and rosette inhibition by antilymphocyte globulin, we have shown that cell-mediated immunity is depressed in megaloblastic anemia due to folate deficiency; this depression was reversed by folate treatment. Cell-mediated immunity was not impaired by iron-deficiency anemia.

Endemic tropical sprue in Africa.

Twenty-four patients have been found who appear to have endemic tropical sprue, with malabsorption on biochemical, radiological and histological grounds. Patients with the tropical sprue syndrome responded equally well clinically and biochemically to folate and tetracycline. Jejunal histology responded least well to treatment.