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Measuring Lactase Enzymatic Activity in the Teaching Lab
Published on: August 6, 2018
Association of lymphocytic colitis and lactase deficiency in pediatric population
Jihong Sun1, Jingmei Lin1, Kalayan Parashette2
1Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Indianapolis, IN 46202, USA.
Insights
Pediatric lymphocytic colitis, a rare condition in children, often presents with diarrhea and is linked to lactase deficiency. Treatment with lactase supplements or dairy avoidance significantly improved symptoms in most young patients.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Pathology
- Immunology
Background:
- Lymphocytic colitis is typically diagnosed in middle-aged to elderly adults.
- Pediatric cases of lymphocytic colitis are infrequently reported in medical literature.
- This study focuses on clinicopathological features and associated conditions in pediatric patients.
Purpose of the Study:
- To characterize the clinical presentation and associated comorbidities of lymphocytic colitis in children.
- To investigate the prevalence of lactase deficiency in pediatric patients with lymphocytic colitis.
- To evaluate the efficacy of lactase supplementation in managing symptoms.
Main Methods:
- Retrospective review of electronic medical records for pediatric patients diagnosed with lymphocytic colitis.
- Analysis of clinical variables including demographics, symptoms, endoscopic findings, and medical history.
- Assessment of duodenal disaccharidase activity and response to lactase treatment.
Main Results:
- Ten pediatric cases of lymphocytic colitis were identified, presenting with diarrhea and occasional abdominal pain.
- The typical patient was a Caucasian female aged 2-18 years.
- A significant association (80%) was found between lymphocytic colitis and lactase deficiency, with symptom improvement upon dairy avoidance or lactase supplementation.
Conclusions:
- The typical pediatric patient with lymphocytic colitis is a Caucasian female.
- Lactase deficiency is a common comorbidity in pediatric lymphocytic colitis.
- Lactase supplementation or dietary modification can effectively manage gastrointestinal symptoms in these patients.
Abstract:
Characterized by colonic mucosa intraepithelial lymphocytosis, lymphocytic colitis is primarily an entity presented in the middle-aged to elderly patient population. Very few large series of lymphocytic colitis of childhood occurrence are available in the medical literature. Ten cases each of lymphocytic colitis and of colonic lymphocytosis of other diagnosis, all with duodenal disaccharidases analysis data, were collected from the files of our institution. The electronic medical records were reviewed and multiple variables were analyzed. The ten patients with lymphocytic colitis presented with diarrhea. Of these, three had abdominal pain. The age range was 2-18 years. Nearly all patients were Caucasian (90%) and 70% were female. Endoscopically, most had normal appearing colonic mucosa. Significant past medical history, family medical history and associated comorbidities included celiac disease, Down syndrome, juvenile arthritis and other autoimmune diseases. Interestingly, the most revealing observation was that the majority of cases (80%) were associated with lactase deficiency and, for the most part, gastrointestinal symptoms improved simply by treatment with Lactaid or avoidance of dairy products. This association is statistically significant. Our clinicopathological study indicates that the typical pediatric patient is a female Caucasian. A large of portion of the patients had associated lactase deficiency and improved on Lactaid supplement alone.
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