1999, a Cluster of Microvillous Inclusion Disease in the Navajo
A cluster of microvillous inclusion disease in the Navajo population John F. Pohl, MD, Mitchell D. Shub, MD, Eric E. Trevelline, MD, Kristy Ingebo, MD, Gary Silber, MD, ANancy Rayhorn, RN, BSN, Steve Holve, MD, and Diana Hu, MD riod.1 The prognosis is generally poor, We report 4 unrelated patients with characteristic microscopic findings of with most patients dying by the second microvillous inclusion disease (MID) with early-onset phenotype. All 4 pa- decade of life as a result of complica- tients came from the Navajo reservation in northern Arizona. A literature tions of parenteral alimentation includ- 4 search revealed a fifth unrelated Navajo child with MID. The unusually ing liver failure or sepsis. Various high incidence in this population indicates that a founder effect might be re- treatments including glucocorticoids, sponsible for an increased frequency of this rare genetic disorder in the pentagastrin, human epidermal growth factor, disodium cromoglycate, adreno- Navajo. It is recommended that all Navajo infants presenting with severe corticotropic hormone, prednisolone, diarrhea during early infancy undergo investigation for MID. (J Pediatr and elemental formula feedings have 1999;134:103-6) failed.5-7 However, somatostatin, which is not universally successful,8 reduced stool output in 2 patients,9,10 with an increased weight velocity Microvillous inclusion disease, a rare children with a specific subset of in- noted in 1.10 Loperamide has only disorder with an unknown cause, re- tractable diarrhea and described com- transiently decreased stool output.1 sults in an intractable secretory diar- plete villous atrophy, crypt hypoplasia, Three patients have received intestinal rhea that begins in early infancy.
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