title: Lactulose/mannitol test: an ideal screen for celiac disease.
abstract: A lactulose/mannitol (La/Ma) test was compared with a standard cellobiose/mannitol test (Ce/Ma) in 17 patients with newly diagnosed celiac disease and 12 healthy controls. The mean La/Ma test was 0.163 (SEM 0.076) in celiacs and 0.016 (SEM 0.002) in controls. The mean Ce/Ma test was 0.132 (SEM 0.024) in celiacs and 0.014 (SEM 0.002) in controls (p less than 0.001). There is no significant difference between the new La/Ma test and the Ce/Ma test. Eighty-two patients referred to a general gastroenterology clinic with symptoms or signs of celiac disease performed a La/Ma test. A jejunal biopsy was indicated in 44 of these. In this selected group the sensitivity was 89%, specificity 54%, and negative predictive value of 95%. The La/Ma test fulfills the criteria of a screening test; it is sensitive, of low cost, and simple to perform, and it has the advantage of a simple enzyme assay and does not cause diarrhea in patients with hypolactasia. It can, therefore, be used in screening large patient populations.
authors.affiliation: Gastroenterology Unit, General Infirmary, Leeds, United Kingdom.
authors.forename: L D
authors.initials: LD
authors.lastname: Juby
authors.forename: J
authors.initials: J
authors.lastname: Rothwell
authors.forename: A T
authors.initials: AT
authors.lastname: Axon
mesh_terms: D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000175:diagnosis* / Q000473:pathology / Q000652:urine; D002475:Cellobiose / Q000652:urine; D004187:Disaccharides; D005260:Female; D006801:Humans; D007583:Jejunum / Q000473:pathology; D007792:Lactulose / Q000652:urine; D008297:Male; D008353:Mannitol / Q000652:urine; D008875:Middle Aged; D011237:Predictive Value of Tests
chemical_list: D004187:Disaccharides; D002475:Cellobiose; D008353:Mannitol; D007792:Lactulose