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Scand J Gastroenterol. 2011 Dec;46(12):1429-34. doi: 10.3109/00365521.2011.619276. Epub 2011 Sep 22.

Disaccharidase deficiency in pediatric patients with celiac disease and intact villi.

Author information

1
The Division of Pediatric Gastroenterology and Nutrition of the Goryeb Children's Hospital, Atlantic Health System, Morristown, New Jersey 07960, USA. rmones1068@aol.com

Abstract

BACKGROUND AND AIMS:

The "gold standard" for the diagnosis of celiac disease (CD) is the small intestinal biopsy. A significant number of biopsies are inadequate for interpretation. Furthermore, the labeling of a biopsy as a Marsh I or II is somewhat subjective and may vary with the experience of the pathologist. Our hypothesis is that patients with intact villi undergoing biopsies frequently have associated disaccharidase deficiencies (DSD).

METHODS:

We reviewed 220 charts of pediatric patients with CD and selected those with a duodenal biopsy Marsh score of I/II. The disaccharidase (DS) levels of these patients were compared with a randomly selected, age-matched control group. DSD is defined as levels below the lower limits of normal.

RESULTS:

Lactase (mean lactase = 18.8 in the control group vs. 4.2 in the diseased group, p = 0.004); sucrase (mean sucrase = 46.4 in the control group vs. 21.4 in the diseased group, p = 0.001); maltase (mean maltase = 138 in the control group vs. 52.5 in the diseased group, p = 0.001); palatinase (mean palatinase = 9.6 in the control group vs. 3.3 in the diseased group, p < 0.001).

CONCLUSION:

There is a profound deficiency of DS levels in pediatric patients with CD who have intact villi.

PMID:
21936724
DOI:
10.3109/00365521.2011.619276
[Indexed for MEDLINE]

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