PT  - JOURNAL ARTICLE
AU  - S P Lamabadusuriya
AU  - S Packer
AU  - J T Harries
TI  - Limitations of xylose tolerance test as a screening procedure in childhood coeliac disease.
AID  - 10.1136/adc.50.1.34
DP  - 1975 Jan 01
TA  - Archives of Disease in Childhood
PG  - 34--39
VI  - 50
IP  - 1
4099  - http://adc.bmj.com/content/50/1/34.short
4100  - http://adc.bmj.com/content/50/1/34.full
SO  - Arch Dis Child1975 Jan 01; 50
AB  - The usefulness of the xylose tolerance test as a screening procedure for coeliac disease has been reassessed in 54 children with suspected coeliac disease. 5- and 24-hour urinary excretion rates of xylose were of no value in discriminating between patients with and without coeliac disease; similarly, the 3-hour blood xylose concentration was nondiscriminatory. Three (15-8%) patients with subtotal villous atrophy and 8 (61-5%) with partial villous atrophy due to coeliac disease had one-hour blood xylose values which fell within the normal range. The effect of withdrawal or reintroduction of dietary gluten on sequential one-hour blood xylose levels was variable and generally unhelpful in predicting those patients who developed gluten-induced mucosal changes. The results of the present study emphasize the serious limitations of the xylose tolerance test as a screening procedure in childhood coeliac disease. It is recommended that the use of the urinary xylose test should be abandoned in the paediatric population. A normal one-hour blood xylose value does not exclude a diagnosis of coeliac disease even in young children who have never received a gluten-free diet. A clinical suspicion of coeliac disease remains the most important single factor in deciding whether to preform a jejunal biopsy.