Anemia impairs small intestinal absorption measured by intestinal permeability in children.
OBJECTIVE
To determine the effect of anemia and iron status on intestinal permeability in children.


METHODS
A routine prospective study was performed in 64 children with symptoms suggesting cow's milk allergy (CMA) (11.8 +/- 16 mo, 2-94 mo). They exhibited a negative cow's milk challenge upon the ESPGHAN criteria. Hemoglobin (Hb), mean corpuscular volume (MCV), blood iron (Fe) and ferritin (Fer) concentrations were studied in all. Permeability was measured as percent of urinary excretion of lactitol (L,%) and mannitol (M,%) (oral absorption, 0.1 g/Kg for each sugar) and determination of the L/M ratio (L/M,%).


RESULTS
L/M was significantly higher in anemic children than in non-anemic ones, 2.45, (median), 1.92-3.43 (extremes), n = 29, vs. 1.72, 1.56-2.18, n = 35, p = 0.03. Hb correlated negatively with L/M (p = 0.0001) and L (p = 0.05) and positively with M (p = 0.03). Also, L/M correlated negatively with MCV (p = 0.001) and Fe (p = 0.04).


CONCLUSIONS
IP depends on anemia and iron status. The interpretation of IP should be taken cautiously into account in the diagnosis of CMA in case of anemia or iron deficiency.
Kalach
N
N
Department of Neonataology-Pediatrics, Cochin-St Vincent de Paul Hospital, Paris cedex 14, France.
Benhamou
P H
PH
Campeotto
F
F
Dupont
Ch
Ch
D000740:Anemia / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004066:Digestive System Diseases / Q000150:complications / Q000503:physiopathology; D004909:Erythrocyte Indices; D005293:Ferritins / Q000097:blood; D006801:Humans; D007223:Infant; D007408:Intestinal Absorption / Q000502:physiology*; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008353:Mannitol / Q000378:metabolism / Q000652:urine; D016269:Milk Hypersensitivity / Q000150:complications / Q000175:diagnosis*; D010539:Permeability; D013402:Sugar Alcohols / Q000378:metabolism / Q000652:urine
D013402:Sugar Alcohols; D008353:Mannitol; D005293:Ferritins; D007501:Iron; C014635:lactitol