Document Detail

Lactulose-mannitol intestinal permeability test in children with diarrhea caused by rotavirus and cryptosporidium. Diarrhea Working Group, Peru.
MedLine Citation:
PMID:  10896065     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The relationship between intestinal permeability and acute secretory diarrheal syndromes caused by rotavirus and Cryptosporidium parvum in infants less than 36 months of age was studied using the lactulose-mannitol excretion assay. METHODS: An oral solution containing 0.4 g/kg lactulose and 0.1 g/kg mannitol was administered to 15 infants with rotavirus, 7 with Cryptosporidium infection and a control group of 7 with secretory diarrhea admitted to the Oral Rehydration Unit of the National Children's Hospital in Lima, Peru. Urinary sugar excretion was measured using an enzymatic spectrophotometric method. The ratio of urinary excretion of lactulose to mannitol was used to measure intestinal mucosal permeability, with higher ratios indicative of increased intestinal permeability. Infants in all three groups were retested 20 days after the initial test. RESULTS: The (mean +/- SE) lactulose:mannitol (L:M) excretion ratios during the acute phase (day 1) of diarrhea in infants with rotavirus or Cryptosporidium and control infants were 0.67 +/- 0.1, 0.76 +/- 0.16, and 0.26 +/- 0.04, respectively. In the convalescent phase (day 20) the ratios were 0.19 +/- 0.02, 0.28 +/- 0.05, and 0.29 +/- 0.07, respectively. Significant reductions in L:M ratios were noted in rotavirus patients between days 1 and 20 (paired t-test; P < 0.01), Cryptosporidium patients between days 1 and 20 (paired t-test; P < 0.05), and between control subjects on day 1 and rotavirus patients on day 1 and Cryptosporidium patients on day 1 (unpaired t-tests; P < 0.05 for both). There were no significant differences in control subjects between days 1 and 20, control subjects and rotavirus patients on day 20, or control subjects and Cryptosporidium patients on day 20. CONCLUSIONS: The results indicate that increased intestinal permeability caused by rotavirus or cryptosporidium infections in Peruvian infants less than 36 months of age is a significant but reversible phenomenon. The temporal relationship observed in the current study and the contribution of such alterations in intestinal mucosal integrity to the burden of diarrheal disease and the development of malnutrition in developing countries is discussed.
Y Zhang; B Lee; M Thompson; R Glass; R I Cama; D Figueroa; R Gilman; D Taylor; C Stephenson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  31     ISSN:  0277-2116     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-11-02     Completed Date:  2001-02-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  16-21     Citation Subset:  IM    
Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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MeSH Terms
Child, Preschool
Cryptosporidiosis / metabolism*,  pathology
Cryptosporidium parvum*
Diarrhea / metabolism*,  pathology
Feces / chemistry,  parasitology,  virology
Infant, Newborn
Intestinal Absorption / physiology
Intestinal Mucosa / metabolism*,  pathology
Lactulose / administration & dosage,  pharmacokinetics*
Mannitol / administration & dosage,  pharmacokinetics*
Rotavirus Infections / metabolism*,  pathology
Reg. No./Substance:
4618-18-2/Lactulose; 69-65-8/Mannitol
Erratum In:
J Pediatr Gastroenterol Nutr 2000 Nov;31(5):578

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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