Pediatrics & Therapeutics
Open Access
ISSN: 2161-0665
+44 1478 350008
ISSN: 2161-0665
+44 1478 350008
Zakharova Irina, Klimov Leonid, Stoyan Marina, Kuryaninova Victoria and Kashnikov Vyacheslav
Russian Medical Academy of Postgraduate Continuing Study, Russia
Stavropol State Medical University, Russia
Children's Clinical Hospital, Russia
Posters & Accepted Abstracts: Pediatr Ther
Aims: Evaluation of lactase activity in biopsy samples of mucous membrane of small intestine (MMSI) in children with coeliac disease (CD). Methods: 50 children with CD aged 1 to 17 years (medium age 8.8Ã?±0.7 years). Patients were randomized to three groups: First-18 (36.0%) patients with acute CD; second-23 (46.0%) children on a strict gluten-free diet (age 5.6Ã?±0.8 years); third-9 (18.0%) patients not on a diet (age 3.9Ã?±0.9 years). Results: In acute CD hypolactasia (HL) occurred in 14 (77.8%) patients, of whom in 10 (55.6%) cases it was severe HL and in 4 (22.2%) cases moderate HL. Correlation analysis showed a negative correlation between lactase activity and anti-tTG level IgA (r=-0.23, p<0.05) and anti-tTG level IgG (r=-0.22, p<0.05). Th e negative correlation between EMA titer (IgA, IgG) and lactase activity (r=-0.46, p<0.02) was observed. Atrophy of Marsh 2 type occurred in 1 (2.0%) child, Marsh 3A type in 12 (24.0%) children, Marsh 3ÃÂ? type in 21 (42.0%) children and Marsh 3C type in 16 (32.0%) children. In patients with severe HL total MMSI atrophy equivalent to Marsh 3á was 1.8 times higher than in children with moderate HL (p<0.05) and 5.8 times higher than in patients with normolactasia (NL) (p<0.01). When on gluten-free diet the rate of severe and moderate HL was 9 (39.1%) and 8 (34.8%), and in patients not on a diet 4 (44.4%) and 3 (33.3%) cases, respectively (p>0.05). Conclusions: Th e maximal level of MMSI atrophy (Marsh 3C) was observed in 47.8% patients with severe HL. Autoimmune antibody titer (EMA, anti-tTG) positively correlate with HL severity in children with CD.
Zakharova Irina is a Professor from Russian Medical Academy of Postgraduate Study in Moscow. She is a Chief of Department of Pediatric Russian Medical Academy of Postgraduate Continuing Study, Moscow and regular Consultant in Pediatrics in Clinic of Russian President Affairs Management and in many private clinics. She is the Member of Editorial Team of Russian medical journals Consilium Medicum and Medical Advice. She has published more than 500 papers.