A disease quite recently included among the deficiency diseases is sprue, observed chiefly in the tropics but seen occasionally also in the United States. Most authorities now classify sprue among the conditions associated with the absence of sufficient vitamin B12 or the animal protein factor in the diet. Similar conditions to those prevailing in sprue are also seen, however, in a rather unusual condition called celiac disease, which occurs in infants, and in idiopathic steatorrhea. In these latter conditions the patient has difficulty in handling fats in the digestive tract. The primary symptom in sprue is difficulty in the formation of the blood, and with it inflammation of the mouth and tongue and difficulty in absorbing fat.
Most frequent among the symptoms of sprue are diarrhea, indigestion, distention of the abdomen, soreness of the mouth and tongue, loss of weight and, with all this, weakness. The condition is likely to come on gradually in people who have been long on a monotonous low-protein diet. The patients are pale, thin, and sometimes have eruptions of the neck, face and hands and extreme redness of the tongue and mouth. Doctors make certain of the diagnosis by using the X-ray and by making studies of the blood and the bone marrow, where the red blood cells are formed.
Fortunately such preparations as liver extract, folic acid, vitamin B12, vitamin K, and a good diet high in protein bring prompt relief to patients with sprue. The symptoms begin to disappear in a few days and in a few weeks, unless there has been too much damage to the tissues, the patient is well on the way to complete recovery.