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Dual sugar permeability testing in diarrheal disease
A M Haase1, R H Kukuruzovic, K Dunn
1NT Clinical School (Flinders University), Royal Darwin Hospital, Casuarina, Northern Territory, Australia.
The Journal of Pediatrics
|February 5, 2000
Summary
Blood tests are a valid alternative for intestinal permeability testing in children, significantly reducing the failure rate compared to urine collection. This method offers a more reliable assessment for young patients with diarrhea.
Area of Science:
- Pediatric Gastroenterology
- Biomedical Diagnostics
Background:
- 5-hour urine collection for sugar permeability tests has a high failure rate in young children.
- Acute gastroenteritis can impact intestinal permeability measurements.
Purpose of the Study:
- To evaluate the validity of using blood specimens for sugar permeability testing.
- To determine if blood tests reduce the failure rate compared to urine tests in children.
Main Methods:
- Simultaneous 5-hour urine and blood collections were performed after ingestion of lactulose and L-rhamnose.
- Sugar levels were measured using high-performance liquid chromatography, and results were expressed as an L-R ratio.
- Intestinal permeability was assessed in 24 children with acute gastroenteritis and 25 controls.
Main Results:
- The lactulose-rhamnose (L-R) ratio in blood for children with gastroenteritis was 9.4 (6.7 to 13.1), compared to 5.9 (4.4 to 7.8) in controls.
- The agreement between blood and urine L-R ratios was substantial (kappa = 0.71).
- The failure rate of the permeability test was significantly lower using blood (10%) versus urine (37%).
Conclusions:
- Intestinal permeability testing using blood specimens is a valid diagnostic alternative in pediatric patients.
- Blood-based testing significantly lowers the failure rate compared to traditional urine collection methods.
- This approach improves the reliability of permeability assessments in young children, particularly those with diarrhea.