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Intestinal disaccharidase deficiencies in gluten-sensitive enteropathy

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Summary

The disaccharidase activity of the intestinal mucosa in 6 patients with gluten-sensitive enteropathy has been described. Intestinal disaccharidase activity was evaluated by disaccharide oral loads and by disaccharidase assay of homogenates of intestinal mucosa. There seemed to be some correlation between abnormalities of structure noted histologically and diminished enzyme activity. A deficiency of several disaccharidases was demonstrated with the concomitant malabsorption of oral sugar loads.

Deficiency of lactase activity appeared to be the most frequent, expressing itself clinically as a lactase deficiency, as well as a lactose intolerance with lactosuria. Histological recovery and prompt symptomatic relief was noted in these patients by removing the offending disaccharide from the diet, as well as excluding gluten. Improvement in intracellular enzyme activity occurred after specific treatment.

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Author notes

  1. Arthur P. Klotz M.D.

    Present address: Children's Medical and Surgical Center, The Johns Hopkins Hospital, Baltimore, Md.

Authors and Affiliations

  1. From the Departments of Pediatrics and Gastroenterology, University of Kansas Medical Center, Kansas City, Kans.

    Fima Flifshitz M.D., Arthur P. Klotz M.D. & Gerald H. Holman M.D.

Authors
  1. Fima Flifshitz M.D.
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  2. Arthur P. Klotz M.D.
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  3. Gerald H. Holman M.D.
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  4. Dorothy McField MT
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Additional information

Aided in part by Grant 00406-02 from the National Institute of Health and Human Development.

We wish to thank Dr. R. M. Lauer for allowing us to study I of his patients: and Drs. S. Karacadag and M. Lubos for obtaining the duodenal biopsies. We are grateful to Dr. H. C. Miller for his critical reading of this manuscript and his suggestions.

John and Mary R. Markle Scholar in Academic Medicine.

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Flifshitz, F., Klotz, A.P., Holman, G.H. et al. Intestinal disaccharidase deficiencies in gluten-sensitive enteropathy. Digest Dis Sci 10, 47–57 (1965). https://doi.org/10.1007/BF02235075

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