Brown bowel syndrome occurring in coeliac disease in the west of Ireland.
Brown bowel syndrome is the name applied to a brown discoloration of the intestine. This is due to lipofuscin deposition in intestinal smooth muscle and occurs in association with malabsorption. Three cases occurring in a coeliac registry of 559 patients are described. One patient presented with acute massive bleeding per rectum, and two were diagnosed at autopsy. The syndrome may be accompanied by vitamin E deficiency and neurologic dysfunction. Two patients had evidence of peripheral neuropathy, and one had low vitamin E levels. Concomitant vitamin D deficiency was present. Fat-soluble vitamin malabsorption, especially if there is a poor response to a gluten-free diet or neuropathy, might alert the clinician to the possibility of brown-bowel syndrome and suggests careful search for lipofuscin in biopsy material, using special histologic techniques.
Connolly
C E
CE
Dept. of Pathology, University College Hospital, Galway, Ireland.
Kennedy
M
M
Stevens
F M
FM
McCarthy
C F
CF
D000368:Aged; D002446:Celiac Disease / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications; D007413:Intestinal Mucosa / Q000378:metabolism*; D007494:Ireland / Q000453:epidemiology; D008062:Lipofuscin / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000378:metabolism; D010523:Peripheral Nervous System Diseases / Q000150:complications; D012042:Registries; D013577:Syndrome; D014811:Vitamin E Deficiency / Q000150:complications
D008062:Lipofuscin