Is the sugar intestinal permeability test a reliable investigation for coeliac disease screening ?
Background-The lactulose/mannitol (L/M) intestinal permeability test is a simple, non-invasive screening test for coeliac disease.
The reliability of the L/M test has so far only been tested in selected groups of patients with coeliac disease.
Aim-To evaluate the reliability of the L/M test in a group of patients with coeliac disease who had been diagnosed during mass serological screening of the general population.
Patients and methods-Twenty nine patients with coeliac disease detected by screening and 54 age matched coeliac disease free controls aged 11-15 years underwent an L/M test with 5 g lactulose and 2 g mannitol in isotonic aqueous solution.
Urinary sugars were measured by high performance liquid chromatography.
The median% urinary recovery of lactulose (lactulose UR) was significantly higher in patients with coeliac disease than in controls (0.63 v 0.18, p<0.001).
The mean mannitol% UR was lower in patients with coeliac disease than in controls (17.6 v 18.5) but the difference was not significant.
The median urinary L%/M% ratio was significantly higher in patients with coeliac disease than in controls (0.038 v 0.014, p<0.001).
However, 16 of the 29 patients with coeliac disease showed an L% a/M% ratio within normal limits (<0.044).
Conclusion-The L/M intestinal permeability test is not a valuable tool for screening of coeliac disease in the general population. (...)
Mots-clés Pascal : Coeliaque maladie, Dépistage, Examen laboratoire, Perméabilité cellulaire, Intestin, Lactulose, Mannitol, Fiabilité, Résultat, Homme, Appareil digestif pathologie, Intestin pathologie, Malabsorption intestinale, Immunopathologie
Mots-clés Pascal anglais : Coeliac disease, Medical screening, Laboratory investigations, Cell permeability, Gut, Lactulose, Mannitol, Reliability, Result, Human, Digestive diseases, Intestinal disease, Intestinal malabsorption, Immunopathology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0197048
Code Inist : 002B13B03. Création : 21/05/1997.