Alpha 1-antitrypsin clearance as an aid in the management of patients with celiac disease.
One hundred and thirty-two different intestinal alpha 1-antitrypsin clearance tests were performed in 48 untreated adult celiac patients, 64 patients taking a gluten-free diet, and 20 adult healthy controls. In the untreated group, 95% of patients had enteric protein loss with values higher than the upper limit of normality (mean +/- 2 SD). In the treated group of patients, only 22% had abnormal levels of alpha 1-antitrypsin clearance. Sixteen patients who had elevated clearance before treatment had decreased clearance after an average of 7.4 months on a gluten-free diet. There was a significant relation (p less than 0.05) between the alpha 1-antitrypsin clearance and the degree of alteration of the jejunal histological structure. We conclude that enteric protein loss is a very frequent finding in celiac patients and the measurement of alpha 1-antitrypsin clearance may be a reliable method to evaluate the activity of the disease and useful in following the efficacy of treatment.
Bai
J C
JC
Small Bowel Section, Hospital Nacional de Gastroenterologia Dr. Carlos Bonorino Udaondo, Buenos Aires, Argentina.
Sambuelli
A
A
Niveloni
S
S
Sugai
E
E
Mazure
R
R
Kogan
Z
Z
Pedreira
S
S
Boerr
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D001798:Blood Proteins / Q000032:analysis; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy / Q000378:metabolism*; D004044:Dietary Proteins / Q000008:administration & dosage; D005243:Feces / Q000737:chemistry; D005260:Female; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011504:Protein-Losing Enteropathies / Q000175:diagnosis / Q000209:etiology; D000515:alpha 1-Antitrypsin / Q000378:metabolism*
D001798:Blood Proteins; D004044:Dietary Proteins; D000515:alpha 1-Antitrypsin; D005983:Glutens