Small Intestinal Permeability in Pediatric Clinical Practice

Hamilton, I.; Hill, A. V. L.; Bose, Bhadran; Bouchier, I. A. D.; Forsyth, J. S.

doi:10.1097/00005176-198709000-00006

Cited by 41 publications

(15 citation statements)

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“…The L/M normal values depicted in the present study, ranging from 1.76% to 2.09%, compares relatively well with previous data obtained in 10 British children aged 3-18 mo, i.e., 1.8-5.00% (21). Wider ranges were observed in 33 Scottish children aged 7 mo to 14 y, i.e., 0.50-9.00% (22). In 30 healthy Dutch children aged 0-16 y, the normal upper limit (mean ‡ 2 SD) of the L/M ratio was 9.00% (23).…”

Section: Discussionsupporting

confidence: 90%

Intestinal permeability in children: variation with age and reliability in the diagnosis of cow's milk allergy

et al. 2001

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Kalach N, Rocchiccioli F, de Boissieu D, Benhamou PH, Dupont C. Intestinal permeability in children: variation with age and reliability in the diagnosis of cow's milk allergy. Acta Paediatr 2001; 90: 499-504. Stockholm. ISSN 0803-5253 Objective: To analyse to what extent age may alter intestinal permeability (IP) in children and to assess its reliability according to clinical manifestations in cow's milk allergy (CMA). Design: A routine prospective study was performed in 200 children (12.5 § 23 mo, 0.5-168 mo) presenting with clinical manifestations suggesting CMA. Controls (n = 105) were those with a negative cow's milk challenge, whereas CMA children (n = 95) ful lled ESPGHAN criteria. Permeability was measured as a percentage of urinary excretion of lactitol (L, %) and mannitol (M, %) (0.1 g/kg for each, oral absorption after a 6 h fast, 5 h urine collection, analysis by gas chromatography) and determination of the L/M ratio (L/M, %). Results: In control children, L/M correlated negatively with age (r ¡0.33, p = 0.0006), whereas in those with CMA no correlation was found. Median L/M was signi cantly higher in CMA children (n = 95) than in controls (n = 105), 4.35 § 7.57% (95% CI 5.30-8.39%) vs 1.97 § 0.87% (95% CI 1.76-2.09%), (p = 0.0001). With a L/M cut-off value de ned as mean ‡ 2 SD of controls, in CMA IP exhibited a 68% sensitivity and a 77% negative predictive value. The highest sensitivity (70%) was seen at ages 6-12 mo and the lowest (58%) at age more than 3 y. An abnormal IP was seen in 80% of CMA children with digestive manifestations, in 43% with extra-digestive, 68% with mixed and 40% with anaphylactic manifestations.Conclusion: IP correlates negatively with age in control children and is altered in children with CMA. The test is at its most accurate in the diagnosis of CMA when done at ages 6-12 mo, when there are digestive manifestations.

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Section: Discussionsupporting

confidence: 90%

Intestinal permeability in children: variation with age and reliability in the diagnosis of cow's milk allergy

et al. 2001

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“…The paracellular pathway is also the presumed route of passage that peptides such as gliadin take through a damaged intestinal mucosa. Using the sugar permeability test, abnormal intestinal permeability has been found in patients with recognized intestinal disorders (32,33). More recently, D'Eufemia et al (34) applied the test to patients with autism.…”

Section: Earlier Studies Point To a Linkage Between Gut Function And mentioning

confidence: 99%

Intestinal Pathophysiology in Autism

White

2003

Exp Biol Med (Maywood)

170

114

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Autism is a life-long developmental disorder affecting as many as 1 in 500 children. The causes for this profound disorder are largely unknown. Recent research has uncovered pathology in the gastrointestinal tract of autistic children. The pathology, reported to extend from the esophagus to the colon, is described here along with other studies pointing to a connection between diet and the severity of symptoms expressed in autism. The evidence that there is impaired intestinal permeability in autism is reviewed, and various theories are discussed by which a leaky gut could develop. Lastly, some possible ways in which impaired gastrointestinal function might influence brain function are discussed.

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“…These changes have mostly been found in selected groups of symptomatic patients. 2 In recent years it has become clear that many patients with coeliac disease escape diagnosis.3 Despite typical coeliac damage at jejunal biopsy, many patients often show only minor symptoms or are apparently healthy. Treatment of these patients with a gluten-free diet is nevertheless recommended to prevent long term complications of coeliac disease, such as infertility or malignancy.4 Many patients with coeliac disease can be identified through serological screening of the general population using markers of coeliac disease such as the antigliadin antibodies (AGAs) as the screening test.5 The reliability of the sugar intestinal permeability test as a screening tool for undiagnosed coeliac disease has not yet been determined.…”

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confidence: 99%