Intractable diarrhoea in infancy in the 1990s: a survey in Italy.
A "quick" prevalence study of intractable diarrhoea (defined as diarrhoea 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 answered questionnaire sent by FAX. 20 cases of intractable diarrhoea were 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); congenital microvillous atrophy (3 cases); chronic pseudo-obstruction (2 cases) and multiple food intolerance (1 case). Undefined 9/20 cases presented atrophy of intestinal mucosa. The age of the beginning of diarrhoea varied from 2 days to 12 years, but was more than 16 months only in some cases with auto-immune enteropathy.


CONCLUSIONS
Intractable diarrhoea has a low prevalence in Italy and remains a rare but very intricating problem. Long-term PN is recommended in most cases: autoimmune enteropathy is the most frequent cause but in about half of the cases the aetiopathogenetic diagnosis is still not defined.
Ventura
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Istituto di Clinica Pediatrica, Policlinico Santa Chiara, University of Pisa, Italy.
Dragovich
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D
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D003968:Diarrhea, Infantile / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D010289:Parenteral Nutrition, Total