Some Factors in Delayed Diagnosis in Nontropical Sprue

Abstract

Four cases of nontropical sprue are presented in which gastrointestinal symptoms were either absent or inconspicuous. The clinical picture was dominated by various nutritional deficiency states, including anemia, osteomalacia, hemorrhagic tendency and edema.

These cases serve to emphasize that the clinical picture of sprue may be incomplete and that this disorder should be suspected when an unexplained nutritional deficiency is present, even in the absence of diarrhea.