title: Hydrogen breath test with D-xylose for celiac disease screening is as useful in the elderly as in other age groups.
abstract: Up to one fifth of celiac disease patients are diagnosed after the age of 60. The hydrogen breath test with D-xylose as substrate (xylose-BT) has proved useful for the diagnosis of adult celiac disease. Our aim was to determine the potential influence of age-related intestinal mucosal changes on the reliability of this test. We reviewed the results of the xylose-BT in 50 patients with clinical celiac disease in whom the diagnosis was confirmed by histology. A control group of 53 patients with various diarrheal disorders and without jejunal mucosal atrophy at biopsy was similarly studied. Both celiac patients and controls were divided into adults (age < or = 60 years) and elderly (age >60 years). Seven of the 50 celiacs and 8 of the 53 controls were in the elderly category (P = NS). In the celiac disease group, no differences were observed between the elderly and adult patient subgroups for basal H2 excretion (22.4 +/- 42 vs 9.7 +/- 11 ppm), delta increase (56 +/- 43 vs 53 +/- 36 ppm), or area under the curve (7,452 +/- 5,546 vs 6,739 +/- 5,951 ppm x min). The false negative rate was similar for celiac adult (7/43) and elderly (2/7, P = ns) patients. Sensitivity of the xylose-BT was 0.83 in adults and 0.71 in the elderly, and specificity 0.51 in adults and 0.50 in the elderly. In conclusion, the results of the xylose-BT in celiac patients are not influenced by age. The xylose-BT is as valuable a tool for the screening of celiac disease in the elderly as it is in younger patients.
authors.affiliation: Department of Pathology, Hospital General Vall d'Hebron, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Casellas
authors.forename: J
authors.initials: J
authors.lastname: Sardi
authors.forename: I
authors.initials: I
authors.lastname: de Torres
authors.forename: J R
authors.initials: JR
authors.lastname: Malagelada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests; D002446:Celiac Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014994:Xylose
chemical_list: D014994:Xylose