[Skip to Content]
[Skip to Content Landing]
Article
January 1969

Intestinal Disaccharidase Activity in Celiac Sprue (Gluten-Sensitive Enteropathy)

Author Affiliations

Oklahoma City

From the Department of Medicine, University of Oklahoma Medical Center and the Neurosciences Section, Oklahoma Medical Research Foundation, Oklahoma City. Doctor Zschiesche was a Gastroenterology trainee of the Public Health Service.

Arch Intern Med. 1969;123(1):33-38. doi:10.1001/archinte.1969.00300110035006
Abstract

Intestinal biopsy specimens from 22 patients with celiac sprue demonstrated the following: (1) Mean disaccharidase and alkaline phosphatase activities increased from low levels associated with severe mucosal lesions to higher levels with moderate or mild lesions. With mild histology, all enzymes assayed were normal, except for low lactase activity in 25%. (2) Comparison of paired specimens from adjacent sites revealed similar morphologic changes in 70% of the pairs. With respect to occurrence of normal or abnormal enzyme activity in the paired samples, lactase activity was the same in all pairs, while the other enzymes were the same in 74% to 86% of the pairs. (3) Although a clinical improvement followed fair adherence to a glutenfree diet, mild histologic changes and a complete return of enzyme activity occurred only in patients who had adhered strictly to the diet.

References
1.
Plotkin, G.R., and Isselbacher, K.J.:  Secondary Disaccharidase Deficiency in Adult Celiac Disease (non Tropical Sprue) and Other Malabsorption States ,  New Eng J Med 271:1033-1037 ( (Nov 12) ) 1964.Crossref
2.
Shmerling, D.H., et al:  Der Sekundare Mangel an Intestinaler Disaccharidasektivität Bei Der Coliakie Zuantitative Bestimmung Der Enzymaktivität und Klinische Beurteilung ,  Helv Paediat Acta 19:507-527 ( (Dec) ) 1964.
3.
Lifshitz, F.; Klotz, A.P.; and Holman, G.H.:  Intestinal Disaccharidase Deficiencies in Gluten-Sensitive Enteropathy ,  Amer J Dig Dis 10:47-57 ( (Jan) ) 1965.Crossref
4.
Weser, E., and Sleisenger, M.H.:  Lactosuria and Lactase Deficiency in Adult Celiac Disease ,  Gastroenterology 48:571-578 ( (May) ) 1965.
5.
Crane, R.K.:  Enzymes and Malabsorption: A Concept of Brush Border Membrane Disease ,  Gastroenterology 50:254-262 ( (Feb) ) 1966.
6.
Rubin, C.E., et al:  Studies of Celiac Disease: I. The Apparent Identical and Specific Nature of the Duodenal and Proximal Jejunal Lesion in Celiac Disease and Idiopathic Sprue ,  Gastroenterology 38: 28-49 ( (Jan) ) 1960.
7.
Rubin, C.E., and Dobbins, W.O., III:  Peroral Biopsy of The Small Intestine ,  Gastroenterolgy 49: 676-697 ( (Dec) ) 1965.
8.
Welsh, J.D.; Rohrer, G.V.; and Porter, M.G.:  The Baker-Hughes Gastrointestinal Biopsy Tube ,  Amer J Dig Dis 11:559-563 ( (July) ) 1966.Crossref
9.
Madanagopalan, N.; Shiner, M.; and Rowe, B.:  Measurements of Small Intestinal Mucosa Obtained by Peroral Biopsy ,  Amer J Med 38:42-53 ( (Jan) ) 1965.Crossref
10.
Dahlqvist, A.:  Method for Assay of Intestinal Disaccharidases ,  Anal Biochem 7:18-25 ( (Jan) ) 1964.Crossref
11.
Klein, B.; Read, P.A.; and Babson, A.L.:  Rapid Method for the Quantitative Determination of Serum Alkaline Phosphatase ,  Clin Chem 6:269-275 ( (June) ) 1960.
12.
Lowry, O.H., et al:  Protein Measurement With Folin Phenol Reagent ,  J Biol Chem 193:265-275 ( (Nov) ) 1951.
13.
Welsh, J.D., et al:  Isolated Lactase Deficiency: Correlation of Laboratory Studies and Clinical Data ,  Arch Intern Med 120:261-269 ( (Sept) ) 1967.Crossref
14.
van de Kamer, J.H.; ten Bokkel Huinink, H.; and Weyers, H.A.:  Rapid Method for the Determination of Fat in Feces ,  J Biol Chem 177:347-355 ( (Jan) ) 1949.
15.
Christiansen, P.A.; Kirsner, J.B.; and Ablaza, J.:  D-xylose and Its Use in the Diagnosis of Malabsorptive States ,  Amer J Med 27:443-453 ( (Sept) ) 1959.Crossref
16.
Lanzkowsky, P.; Lloyd, E.A.; and Lakey, M.E.:  The Oral D-xylose Test in Healthy Infants and Children ,  JAMA 186:517-519 ( (Nov 2) ) 1963.Crossref
17.
Sheldon, W., and Tempany, E.:  Small Intestine Peroral Biopsy in Coeliac Children ,  Gut 7:481-489 ( (Oct) ) 1966.Crossref
18.
Roy-Choudhury, D.C., et al:  Multiple Jejunal Biopsies in Adult Celiac Disease ,  Amer J Dig Dis 12:657-663 ( (July) ) 1967.Crossref
19.
Benson, G.D.; Kowlessar, O.D.; and Sleisenger, M.H.:  Adult Celiac Disease With Emphasis Upon Response to the Gluten-Free Diet ,  Medicine 43:1-40 ( (Jan) ) 1964.Crossref
20.
Bayless, T.M.; Yardley, J.H.; and Hendrix, T.R.:  Adult Celiac Disease: Treatment With a Gluten-Free Diet ,  Arch Intern Med 111:83-92 ( (July) ) 1963.Crossref
21.
Yardley, J.H., et al:  Celiac Disease: A Study of the Jejunal Epithelium Before and After a Gluten-Free Diet ,  New Eng J Med 267:1173-1179 ( (Dec) ) 1962.Crossref
×