To Spr - the disease of an unknown etiology which is shown in disturbance of intestinal absorption is eurysynusic among indigenous people of India, the Far and Middle East, Caribbean countries, natives of South Africa and, perhaps, Zimbabwe. To Spr can also strike the Europeans who moved to these countries, and his signs can remain for many years. In chronic cases disturbance of absorption of B12 vitamin and the megaloblastny anemia caused by deficit of this vitamin can be the only display of an illness. In other cases also the steatorrhea is observed.
At inspection of the patient with megaloblastny anemia it is always important to establish whether he during some period lived in the region where he to a spr is a local disease. If the picture of anemia does not keep within a framework of the known diseases, then it is necessary to think about a spra. For confirmation of such diagnosis it is necessary to study intestinal absorption of fats, xyloses, B12 vitamin, to make a biopsy of a mucous membrane of a small bowel, and also to carry out tests for identification of Gardia lamblia. At patients deficit of both B12 vitamin, and folic acid can develop.
Treatment to a spr. Treatment has to consist in correction of food deficit and introduction of an antibiotic of a wide range like tetracycline; after a course of treatment it is necessary to repeat the test for B12 vitamin absorption. At extreme situations appoint glucocorticosteroids and steroid hormones. In chronic cases residence in the countries with hot climate is not recommended to a spr.