Excellent agreement between genetic and hydrogen breath tests for lactase deficiency and the role of extended symptom assessment

Pohl, D; Savarino, E; Hersberger, M; Behlis, Z; Stutz, B; Goetze, O; Eckardstein, A V; Fried, M; Tutuian, R (2010). Excellent agreement between genetic and hydrogen breath tests for lactase deficiency and the role of extended symptom assessment. British journal of nutrition, 104(6), pp. 900-7. Cambridge: Cambridge University Press 10.1017/S0007114510001297

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Clinical manifestations of lactase (LCT) deficiency include intestinal and extra-intestinal symptoms. Lactose hydrogen breath test (H2-BT) is considered the gold standard to evaluate LCT deficiency (LD). Recently, the single-nucleotide polymorphism C/T(-13910) has been associated with LD. The objectives of the present study were to evaluate the agreement between genetic testing of LCT C/T(-13910) and lactose H2-BT, and the diagnostic value of extended symptom assessment. Of the 201 patients included in the study, 194 (139 females; mean age 38, range 17-79 years, and 55 males, mean age 38, range 18-68 years) patients with clinical suspicion of LD underwent a 3-4 h H2-BT and genetic testing for LCT C/T(-13910). Patients rated five intestinal and four extra-intestinal symptoms during the H2-BT and then at home for the following 48 h. Declaring H2-BT as the gold standard, the CC(-13910) genotype had a sensitivity of 97% and a specificity of 95% with a of 0.9 in diagnosing LCT deficiency. Patients with LD had more intense intestinal symptoms 4 h following the lactose challenge included in the H2-BT. We found no difference in the intensity of extra-intestinal symptoms between patients with and without LD. Symptom assessment yielded differences for intestinal symptoms abdominal pain, bloating, borborygmi and diarrhoea between 120 min and 4 h after oral lactose challenge. Extra-intestinal symptoms (dizziness, headache and myalgia) and extension of symptom assessment up to 48 h did not consistently show different results. In conclusion, genetic testing has an excellent agreement with the standard lactose H2-BT, and it may replace breath testing for the diagnosis of LD. Extended symptom scores and assessment of extra-intestinal symptoms have limited diagnostic value in the evaluation of LD.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology

UniBE Contributor:

Tutuian, Radu

ISSN:

0007-1145

Publisher:

Cambridge University Press

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:10

Last Modified:

27 Apr 2018 10:19

Publisher DOI:

10.1017/S0007114510001297

PubMed ID:

20398434

Web of Science ID:

000281888300017

BORIS DOI:

10.7892/boris.1649

URI:

https://boris.unibe.ch/id/eprint/1649 (FactScience: 203435)

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