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Intestinale Aktivität von Disaccharidasen und alkalischer Phosphatase in Jejunumbiopsien bei kindlichen Dünndarmerkrankungen

Intestinal disaccharidase and alkaline phosphatase activities of jejunal biopsies in small bowel diseases of children

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Abstract

Intestinal disaccharidase activities were determined in 294 jejunal biopsies obtained from 254 children with various disorders of the small bowel, and alkaline phosphatase activity was measured in 251 biopsies. In normal mucosa a broad range of enzyme activity was found corresponding with the data in the literature.

A primary disaccharidase deficiency was observed in 5 children with congenital sucraseisomaltase deficiency and in a 12-year-old Egyptian boy with acquired lactase deficiency.

A secondary generalized depression of disaccharidase activity and a diminution of alkaline phosphatase activity existed chiefly in patients who had severe or moderate mucosal damage, also in active coeliac disease and during gluten loading, in protracted diarrhoea of infancy, chronic malabsorption of unknown origin and agammaglobulinemia. During remissions enzyme activities recovered together with mucosal improvement. Low levels of enzyme activities were also seen in some cases of protracted diarrhoea of infancy and chronic malabsorption of unknown origin although only mild mucosal lesions were demonstrated.

Zusammenfassung

In 294 Jejunumbiopsien von 254 Kindern mit verschiedenen Dünndarmerkrankungen wurde die Aktivität der intestinalen Disaccharidasen und in 251 Biopsien die Aktivität der alkalischen Phosphatase bestimmt. Bei Vorliegen einer normalen Mucosa fand sich eine breite Streuung der Enzymaktivitäten, die mit den Angaben im Schrifttum übereinstimmte.

Ein primärer Disaccharidasemangel wurde bei 5 Kindern mit kongenitalem Saccharase-Isomaltase-Mangel sowie bei einem 12jährigen Jungen ägyptischer Herkunft mit erworbenem Lactasemangel beobachtet.

Eine sekundäre, generelle Erniedrigung der Disaccharidaseaktivitäten und eine Verminderung der Aktivität der alkalischen Phosphatase bestand besonders dann, wenn schwere oder mittelschwere Mucosaveränderungen nachweisbar waren, so in der aktiven Phase der Cöliakie und unter Glutenbelastung, bei protrahierter infantiler Diarrhoe, chronischer Malabsorption unklarer Genese und Agammaglobulinämie. In der Remissionsphase erholten sich gleichzeitig mit der Restitution der Mucosa auch die Enzymaktivitäten. Bei protrahierter infantiler Diarrhoe und bei chronischer Malabsorption unklarer Genese zeigte sich in mehreren Fällen auch dann eine deutliche Verminderung der Enzymaktivitäten, wenn nur leichte Schleimhautveränderungen vorhanden waren.

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  1. Universitäts-Kinderklinik Hamburg, Hamburg, Deutschland

    Th. Lücking

  2. Kinderklinik der Medizinischen Hochschule Hannover, Hannover, Deutschland

    Th. Lücking

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Lücking, T. Intestinale Aktivität von Disaccharidasen und alkalischer Phosphatase in Jejunumbiopsien bei kindlichen Dünndarmerkrankungen. Eur J Pediatr 121, 263–277 (1976). https://doi.org/10.1007/BF00443019

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