Clinicopathologic analysis of malabsorption syndrome in a tertiary care center in South India

Dear Editor, We thank the reader for his/her valuable comments on our article. POINTS 1 AND 2 Since our study was conducted at a single center, we acknowledge the limitations of the patient data and the findings’ generalizability. Our institution is a tertiary care hospital with well-established and well-equipped specialty departments. Most of the cases discussed here originate from the surrounding area. In light of this, the study’s findings can be relatively generalized. This research considers those restrictions and draws relevant inferences from our data. POINT 3 The prevalence of celiac disease in South India is lower. We acknowledge this restriction, and the standard procedure for determining a celiac disease diagnosis is serology followed by duodenal biopsy confirmation. Our investigation turned up no proof that a certain nutritional background is more conducive to celiac disease. Nonetheless, there may be morphological similarities between tropical sprue and celiac disease, with varying degrees of small intestine mucosal villus atrophy, and both conditions are clinically associated with malabsorption. The cost-effectiveness of patient groups in resource-constrained settings should also be considered in the diagnostic workup. POINT 4 We are grateful that the reviewer is interested in information on treatment responses or long-term follow-up data. Retrieving treatment responses and follow-up was challenging because this is a retrospective study. It might be explored in subsequent research. POINT 5 The majority of the cases in our research had morphological evidence of tropical sprue and intraepithelial lymphocytosis. Other possible causes, including newborn enteropathies, eosinophilic and allergic gastroenteritis, and small gut syndrome, were not observed in our study population. In conclusion, we believe that our comprehensive review of the proposed hypothesis will aid pathologists in identifying malabsorption instances. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.