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Screening tests for enteropathy in children.

J J Levine, E Seidman, W A Walker

    American Journal of Diseases of Children (1960)
    |April 1, 1987
    PubMed
    Summary
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    For childhood enteropathy screening, the D-xylose absorption test and fecal fat test better predict normal jejunal biopsy results than the lactose breath hydrogen test. Combining tests did not improve accuracy.

    Area of Science:

    • Pediatric Gastroenterology
    • Diagnostic Accuracy
    • Enteropathy Screening

    Background:

    • Enteropathy in children requires accurate diagnostic methods.
    • Lactose breath hydrogen, D-xylose absorption, and fecal fat tests are common screening tools.
    • Direct comparison of these tests against jejunal biopsy is lacking.

    Purpose of the Study:

    • To compare the diagnostic accuracy of three screening tests for childhood enteropathy against jejunal biopsy.
    • To determine which screening test best predicts a normal jejunal biopsy result.

    Main Methods:

    • Retrospective analysis of jejunal biopsy results from July 1983 to July 1984.
    • Comparison of biopsy findings with results from lactose breath hydrogen, D-xylose absorption, and fecal fat tests.

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    Main Results:

    • No single screening test was ideal.
    • Lactose breath hydrogen test showed low sensitivity and specificity, with poor correlation to biopsy results.
    • D-xylose absorption and fecal fat tests showed significant correlation with biopsy results.
    • A normal result from either the D-xylose or fecal fat test strongly predicted a normal biopsy.
    • Combining multiple tests did not enhance predictive value.

    Conclusions:

    • The D-xylose absorption test is preferable for screening childhood enteropathy due to its sensitivity and patient compliance.
    • Fecal fat determination is also a reliable predictor of normal jejunal biopsy results.
    • Further research may explore optimizing screening strategies for pediatric enteropathy.