Intestinal protein loss in acute and persistent diarrhea of early childhood.
OBJECTIVE
To determine fecal protein loss in children with acute and persistent diarrhea.


BACKGROUND
In children with diarrhea, ongoing losses of endogenous proteins have been suggested as contributing to impairment of nutritional and immunologic status. However, there is a paucity of information and inconclusive data in the literature.


METHODS
Fecal protein loss was assessed prospectively in children (<3 years of age) with acute diarrhea (<7 days' duration) or persistent diarrhea (>14 days) and in controls using alpha-1-antitrypsin determination; fecal protein loss then was correlated with age, duration of diarrhea, nutritional status, plasma proteins, and stool pathogens.


RESULTS
Children with acute diarrhea (n = 43) and those with persistent diarrhea (n = 41) had significantly higher fecal alpha-1-antitrypsin levels compared with controls (n = 14) (2.26 +/- 1.71 and 2.25 +/- 1.51, respectively, vs. 1.02 +/- 0.73 mg/g stools; p = 0.002). However, there was no significant decrease of plasma albumin, globulin, or immunoglobulins. Fecal protein loss did not differ significantly among stool pathogens (bacterial, viral, and parasitic) and demonstrated no significant correlation with age, duration of diarrhea, or nutritional status (mild malnutrition).


CONCLUSIONS
Enhanced fecal protein loss was observed in more than 50% of children with acute and persistent diarrhea caused by various pathogens. This did not correlate with age, duration of diarrhea, or nutritional status and did not result in significant decrease of plasma proteins or immunoglobulins. This protein-losing enteropathy does not appear to have a causal role in perpetuation of diarrheal episodes in children with mild malnutrition.
Weizman
Zvi
Z
Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel. wzvi@bgumail.bgu.ac.il
Binsztok
Mauricio
M
Fraser
Drora
D
Deckelbaum
Richard J
RJ
Granot
Esther
E
D000208:Acute Disease; D001942:Breast Feeding; D003968:Diarrhea, Infantile / Q000209:etiology / Q000378:metabolism*; D005243:Feces / Q000737:chemistry*; D006801:Humans; D007223:Infant; D009752:Nutritional Status; D011506:Proteins / Q000378:metabolism*; D000515:alpha 1-Antitrypsin / Q000032:analysis*
D011506:Proteins; D000515:alpha 1-Antitrypsin