Abstract
No study has compared the 3 most commonly used screening tests for enteropathy and jejunal biopsy results. A retrospective survey of all jejunal biopsies at CHMC (7/83-7/84) was undertaken to evaluate which test best predicted a normal biopsy. Screening tests: Lactose breath hydrogen test (LBHT, 2gm/kg, max 50gm; abnormal>10ppm rise after 60min); serum D-xylose (Xyl, 0.5 gm/kg, max 25gm; abnormal 10% of intake over 72 hours). Histology was reviewed and scored blindly as N (normal-minimal villous blunting) or Abn. (moderate-severe villous atrophy, crypt hyperplasia). Results: Jejunal biopsies were obtained from 117 children. 49 patients had no prior screening test and were excluded. Conclusions: None of the screening tests analyzed were ideal. Xyl and FF were significantly correlated with biopsy results. A normal result in either was highly predictive of a normal biopsy. The xylose test is preferable on the basis of greater sensitivity and ease of patient compliance.
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