THE ADRENAL GLAND IN TROPICAL SPRUE

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Abstract
The exact mechanism by which the "sprue syndrome" develops is still unknown, but the syndrome, as seen in some patients with this condition, embraces many features that are suggestive of adrenal hypofunction, such as asthenia, loss of weight, gastrointestinal symptoms, hypotension, a flat oral glucose tolerance test, and hyperpigmentation of the skin. It has been observed that in sprue certain gastrointestinal symptoms, like flatulence, abdominal distention, and soft or diarrheic stools, frequently precede the development of anemia. This suggests that the initial abnormality may be related to the impaired absorption of essential foodstuffs from the gastrointestinal tract. Thorn and Clinton1 found some abnormalities in carbohydrate metabolism in 75% of 52 untreated patients with Addison's disease. These consisted of a tendency to a low fasting blood sugar level, a flat oral glucose tolerance curve, a normal level in the intravenous glucose tolerance curve, and a tendency to hypoglycemia. The authors

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