Classification of malabsorption syndrome

In pediatric practice, malabsorption syndrome occurs at different ages with different frequencies. At the same time, the peculiarity of the course of the syndrome was noted, depending on the age at which it appeared( for example, in newborns, infants, young children).Therefore attention is drawn to the classification of M. Anient( 1972), in which this feature of the malabsorption syndrome was taken into account.

I. During the newborn period:

1) congenital deficiency of lactase;

2) secondary disaccharidized malabsorption;

3) congenital glucose-30-galactose malabsorption;

4) secondary monosaccharide malabsorption;

5) cystic fibrosis;

6) intolerance to cow's milk protein, soy protein;

7) short-bowel syndrome;

8) congenital chloride diarrhea;

9) primary hypomagnesemia;

10) deficiency of enterokinase;

11) Wiskott-Aldrich syndrome;

12) malabsorption of vitamin B12;

13) enteropathic acrodermatitis.

II.At the age from 1 month to 2 years:

1) deficiency of sugar-isomaltase;

2) secondary deficiency of disaccharidases;

3) secondary malabsorption of monosaccharides;

4) cystic fibrosis;

5) pancreatic insufficiency with bone marrow dysfunction( Schwakhman-Diamond syndrome);

6) celiac sprue;

7) protein sensitization of cow's milk;

8) intestinal lymphangiectasia;

9) helminthic invasion;

10) abetalipoproteinemia;

11) deficiency of enterokinase;

12) obstruction, atresia of the biliary tract: neonatal hepatitis, biliary atresia, bile duct cyst;

13) primary immune deficiency( Wiskott-Aldrich syndrome);

14) Whipple's disease;

15) malabsorption of amino acids;

16) Wolman's disease;

17) vitamin B12 malabsorption syndrome;

18) the Immerslund-Gresbek syndrome;

19) Congenital malabsorption of folic acid;

20) Stasis syndrome;

21) enteropathic acrodermatitis.

III.At the age of 2 years to puberty:

1) secondary disaccharidase insufficiency;

2) celiac disease;

3) tropical sprue;

4) helminthic invasion;

5) Stasis syndrome;

6) primary immunodeficiency;

7) insufficiency of the internal factor.

For a long time it was thought that malabsorption syndrome should be suspected in those cases in which there is a loose stool not caused by intestinal infection. But with violation of intestinal absorption, the stool can be normal, and even periodically there may be constipation. Therefore, an attempt to classify the malabsorption syndrome according to the nature of the stool is justified.

Diseases in which the syndrome of impaired intestinal absorption is accompanied by a normal stool:

1) primary hypomagnesemia;

2) malabsorption of amino acids;

3) malabsorption of vitamin B12;

4) malabsorption of folic acid.

Thus, the syndrome of impaired intestinal absorption develops in many pathological conditions and is characterized by similar clinical signs, which creates certain difficulties and leads to a late diagnosis.