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"The only thing that all of the people with APS Type 1 have in common is the will to survive" -- Pablo Ramírez

 
 
 

Thank you for reply before re calcium +irish girl.she is now 18 and in hospital cacium stayed up after vitamin d injection but still has diarrohea and very low potassium even with infusions.trying to stop diarrohea but nothing seems to work .has become very underweight.

response

Posted by dr at Nov 18, 2009 07:38 PM
Yes diarrhea can be quite a problem with APS-1 and it has several causes. Celiac disease is one. This can be screened for by antibodies (both IgA and IgG subtypes) in the blood for tissue transglutaminase (TTG). Sometimes there is IgA deficiency which can be screened for by a blood test. In the latter case, giardia or bacterial overgrowth of the upper small intestine may be the cause and can be helped by antibiotics or metroniadazole. Patients can also develop autoimmunity to the serotonin rich endocrine cells of the intestine (antibodies against tryptophan hydroxylase which are markers for this problem are I believe not commercially available). The latter may respond to immunosuppressive therapy. In any event, potassium needs to be replaced meantime. Calcium supplements which she needs may help also. Probiotics may be useful. Avoidance of fatty or oily foods will help until the diarrhea has lessened.

Noel Maclaren MD