A. Ventura et D. Dragovich, INTRACTABLE DIARRHEA IN INFANCY IN THE 1990S - A SURVEY IN ITALY, European journal of pediatrics, 154(7), 1995, pp. 522-525
A ''quick'' prevalence study of intractable diarrhoea (defined as diar
rhoea lasting more than 3 weeks and dependent on parenteral nutrition
[PN] for more than 50% of daily caloric intake) was conducted by FAX.
All 35 paediatric gastroenterology services which had been contacted a
nswered questionnaire sent by FAX. 20 cases of intractable diarrhoea w
ere identified in 9 centres. In 12 cases PN was administered at home,
the other 8 cases being treated as inpatients for an average duration
of 9.5 months. A diagnosis had been established in 11 out of 20 cases.
Auto-immune enteropathy was the most frequent diagnosis (5 cases); co
ngenital microvillous atrophy (3 cases); chronic pseudo-obstruction (2
cases) and multiple food intolerance (1 case). Undefinied 9/20 cases
presented atrophy of intestinal mucosa. The age of the beginning of di
arrhoea varied from 2 days to 12 years, but was more than 16 months on
ly in some cases with auto-immune enteropathy. Conclusion Intractable
diarrhoea has a low prevalence in Italy and remains a rare but very in
tricating problem. Long-term PN is recommended in most cases: auto-imm
une enteropathy is the most frequent cause but in about half of the ca
ses the aetiopathogenetic diagnosis is still not defined.