Document Detail

Improved screening for intestinal villous atrophy by D-xylose breath test.
MedLine Citation:
PMID:  10695607     Owner:  NLM     Status:  MEDLINE    
The hydrogen breath test (H2BT) with D-xylose has proven valid in both early recognition and follow-up of intestinal malabsorption. To further evaluate the specificity of the H2BT with D-xylose in the diagnosis of intestinal malabsorption as compared to the conventional urinary D-xylose test, we analyzed the result in 49 patients referred to our unit with a clinical diagnosis of intestinal malabsorption. These patients had an abnormal 25-g D-xylose H2BT but a normal conventional urinary D-xylose test. Jejunal biopsy with Watson capsule was performed in all patients. H&E staining was prepared from each biopsy specimen, and histological changes were classified according to the Marsh criteria. Jejunal biopsy showed mucosal atrophy in 5 patients (10%), hyperplastic lesion in 11 (22.5%), infiltrative lesion in 14 (28.5%), and normal appearance in 19 (39%). G. lamblia infection was additionally diagnosed in two patients. Histological changes were independent of the presence of diarrhea, weight loss, abdominal pain, or anemia. H2 excretion, assessed as increase over baseline and area under the curve, was similarly independent of the histological pattern. In conclusion, performance of a D-xylose H2BT in patients with a normal urinary test reveals a significant number of patients with intestinal mucosal atrophy who might otherwise remain undiagnosed.
F Casellas; I de Torres; J R Malagelada
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  45     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-03-17     Completed Date:  2000-03-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  18-22     Citation Subset:  AIM; IM    
Department of Pathology, Hospital General Vall d'Hebron, Barcelona, Spain.
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MeSH Terms
Breath Tests*
Celiac Disease / diagnosis*
Hydrogen / diagnostic use
Intestinal Mucosa / pathology
Jejunum / pathology*
Microvilli / pathology
Middle Aged
Reg. No./Substance:

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