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One-hour blood xylose test: a reliable index of small bowel function
Insights
The oral D-xylose tolerance test, specifically the one-hour blood level, is a reliable screening tool for pediatric celiac disease and other small bowel disorders causing malabsorption.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Testing
- Malabsorption Syndromes
Background:
- Celiac disease and other small bowel disorders are significant causes of malabsorption in children.
- Accurate and reliable diagnostic methods are crucial for early detection and management.
Purpose of the Study:
- To evaluate the reliability of the oral D-xylose tolerance test in a pediatric population.
- To compare the efficacy of the D-xylose test with fecal fat analysis for screening celiac disease.
- To assess the utility of the D-xylose test in identifying other causes of small bowel mucosal impairment.
Main Methods:
- Retrospective analysis of oral D-xylose tolerance tests in 435 pediatric patients.
- Comparison of one-hour post-load D-xylose levels between normal subjects, children with celiac disease, cystic fibrosis, and other conditions.
- Evaluation of factors such as sex, age, weight, and body surface on test results.
Main Results:
- A significant difference in one-hour D-xylose levels was observed between normal subjects and untreated children with celiac disease.
- The one-hour D-xylose value demonstrated higher reliability than fecal fat analysis for screening celiac disease.
- Children with cystic fibrosis showed delayed D-xylose clearance, while nonceliac children with low levels had upper small bowel mucosal impairment.
- Sex, age, weight, and body surface did not affect one-hour D-xylose levels in control subjects.
Conclusions:
- A single one-hour post-load blood D-xylose estimation is a reliable index of small bowel mucosal function in children.
- The D-xylose tolerance test is an effective screening tool for pediatric celiac disease.
- This test is also valuable for identifying other pediatric small bowel disorders associated with malabsorption.
Abstract:
A retrospective analysis of oral D-xylose tolerance tests in 435 pediatric patients was performed. A significant difference was found between 126 normal subjects and 47 untreated children with celiac disease one hour after load. The one-hour value was found to be more reliable than was fecal fat analysis in screening children for celiac disease. Sex, age, weight, and body surface did not influence the results of the one-hour value in the control subjects. Forty-eight children with cystic fibrosis had one-hour xylose levels within the normal range, but the means at 90, 120, and 180 minutes after load exceeded significantly (P less than 0.01) those of the controls. In a nonceliac group of 63 children with abnormally low xylose levels, almost all were found to have clinical conditions compatible with upper small bowel mucosal impairment. This study shows that a single estimation of xylose in blood one hour after load is a reliable index of small bowel mucosal function. It is a good screening test for celiac disease and small bowel disorders producing malabsorption in children.