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- W2028304994 abstract "The association of giardiasis and malabsorption of vitamin Bi2 is well known, although the mechanism remains unclear. Invasion of duodenal and jejunal mucosa by the para site8 with resultant reduction of mucosal enzyme activity 9 has been demonstrated, but this is unlikely to account for the abnormal absorption of vitamin B12, since the latter occurs primarily in the distal ileum. Potentiation of the parasite-induced intestinal lesions by bacteria ~0 likewise offers no explanation. Direct uptake of the vitamin by the parasite has been suggeste& but not proved, although this has been shown to be the case with the tapeworm Diphyllobothrium latum. I~ Thus, the parasite load might be an important factor in the interference with vitamin BI2 absorption, In Patient 1 it is possible that the post-treatment improvement in Schilling test results was caused by a reduced level of Giardia infestation, and that with complete eradication of the parasite a fully normal result might be obtained. There is abundant evidence suggesting a role for the immune system in controlling infection with Giardia lamblia. Acquired resistance in man is suggested by the lower prevalence of cysts in stools of long-term residents of areas endemic for giardiasis compared to that in stools of temporary visitors to these areas. 12 Experiments performed in mice have shown that the development of acquired resistance to Giardia requires the presence of an intact cell-mediated immune system. 13 In addition, breast milk of immune mice was found to be protective against infection with Giardia larnblia, ~4 suggesting a role for secretory antibodies in host defense against this parasite. The reported rarity of Giardia infestation in X-linked agammaglobulinemia has, therefore, been perplexing. The three patients described here, however, indicate that it may not be rare. Infestation with Giardia lamblia must not be overlooked as a possible etiology of gastrointestinal symptoms in patients with X-linked as well as in those with common variable agammaglobulinemia." @default.
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- W2028304994 title "Correlation between changeable human milk constituents and milk intake in breast-fed babies" @default.
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- W2028304994 doi "https://doi.org/10.1016/s0022-3476(82)80189-3" @default.
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