title: Disaccharidase deficiency in pediatric patients with celiac disease and intact villi.
abstract: OBJECTIVE
  The "gold standard" for the diagnosis of celiac disease (CD) is the small intestinal biopsy. A significant number of biopsies are inadequate for interpretation. Furthermore, the labeling of a biopsy as a Marsh I or II is somewhat subjective and may vary with the experience of the pathologist. Our hypothesis is that patients with intact villi undergoing biopsies frequently have associated disaccharidase deficiencies (DSD).
  
  
  METHODS
  We reviewed 220 charts of pediatric patients with CD and selected those with a duodenal biopsy Marsh score of I/II. The disaccharidase (DS) levels of these patients were compared with a randomly selected, age-matched control group. DSD is defined as levels below the lower limits of normal.
  
  
  RESULTS
  Lactase (mean lactase = 18.8 in the control group vs. 4.2 in the diseased group, p = 0.004); sucrase (mean sucrase = 46.4 in the control group vs. 21.4 in the diseased group, p = 0.001); maltase (mean maltase = 138 in the control group vs. 52.5 in the diseased group, p = 0.001); palatinase (mean palatinase = 9.6 in the control group vs. 3.3 in the diseased group, p < 0.001).
  
  
  CONCLUSIONS
  There is a profound deficiency of DS levels in pediatric patients with CD who have intact villi.
authors.affiliation: The Division of Pediatric Gastroenterology and Nutrition of the Goryeb Children's Hospital, Atlantic Health System, Morristown, New Jersey 07960, USA. rmones1068@aol.com
authors.forename: Richard L
authors.initials: RL
authors.lastname: Mones
authors.forename: Abena
authors.initials: A
authors.lastname: Yankah
authors.forename: Diane
authors.initials: D
authors.lastname: Duelfer
authors.forename: Rami
authors.initials: R
authors.lastname: Bustami
authors.forename: Geraldine
authors.initials: G
authors.lastname: Mercer
mesh_terms: D001706:Biopsy; D016022:Case-Control Studies; D002446:Celiac Disease / Q000201:enzymology* / Q000473:pathology*; D002648:Child; D004186:Disaccharidases / Q000032:analysis / Q000172:deficiency*; D004386:Duodenum / Q000201:enzymology* / Q000473:pathology; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000201:enzymology* / Q000473:pathology; D043322:Lactase / Q000032:analysis; D016015:Logistic Models; D008297:Male; D008871:Microvilli / Q000473:pathology; D011237:Predictive Value of Tests; D013393:Sucrase / Q000032:analysis; D000520:alpha-Glucosidases / Q000032:analysis
chemical_list: D004186:Disaccharidases; C022310:palatinase; D043322:Lactase; D000520:alpha-Glucosidases; D013393:Sucrase