title: Brown bowel syndrome occurring in coeliac disease in the west of Ireland.
abstract: 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.
authors.affiliation: Dept. of Pathology, University College Hospital, Galway, Ireland.
authors.forename: C E
authors.initials: CE
authors.lastname: Connolly
authors.forename: M
authors.initials: M
authors.lastname: Kennedy
authors.forename: F M
authors.initials: FM
authors.lastname: Stevens
authors.forename: C F
authors.initials: CF
authors.lastname: McCarthy
mesh_terms: 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
chemical_list: D008062:Lipofuscin