Disaccharidases in coeliac disease

Area of Science:

• Pediatric Gastroenterology
• Gastrointestinal Physiology

Background:

• Malabsorption in children presents with varied symptoms.
• Congenital enzyme deficiencies are a consideration but often excluded.
• Coeliac disease is a common cause of pediatric malabsorption.

Purpose of the Study:

• To investigate disaccharidase enzyme activities in children with malabsorption symptoms.
• To correlate enzyme activity with histological findings in jejunal biopsies.
• To assess the diagnostic utility of disaccharidase assays in coeliac disease.

Main Methods:

• Jejunal biopsies were obtained from 30 children with malabsorption symptoms.
• Histology was performed to assess villous atrophy.
• Activities of lactase, saccharase, and maltase were determined in tissue samples.

Main Results:

• Coeliac disease was confirmed in 23 out of 30 cases.
• Decreased disaccharidase activity was observed in cases with villous atrophy.
• Lactase activity was most frequently reduced (69% absent), followed by saccharase (29%) and maltase (4%).
• No strong correlation was found between the degree of villous atrophy and enzyme activity levels.

Conclusions:

• Reduced disaccharidase activity indicates impaired disaccharide splitting capacity, not necessarily symptomatic malabsorption.
• Routine determination of disaccharidase activities is not recommended for diagnosing coeliac disease.