Sorbitol H2-breath test versus.pdf

ALIMENTARY TRACT DIGEST LIUER DIS 2002;34:846-50 Sorbitol Hz-breath test versus anti-endomysium antibodies to assess histological recovery after gluten-free diet in coeliac disease A. Tursi G. Brandimartel G. M. Giorgetti2 Fmm Emergency Department I. Bonomo”, Hospital, Andrie ISA); ’ Department of Internal Medicine, Digestive fndoscopy Unit, “Grist0 Re” Hospital, Rome; 2 Department of Internal Medicine, “S. Eugenio” Hospital, Rome, Italy. -b- Dr. A. Tursi, Geiieria Pisani 4, 70031 Andria [Sal, Italy. Fax: +3G-OB83-2GO225. f-mail: antotursi@tiscali.it Submitted January 29 2002. Accepted after revision July IO, 2002. Background. Gluten-free diet plays a key role in treatment of coeliac disease, but it is difficult to evaluate its effect on improvement of vil- lous architecture using sensitive non-invasive tests. Aims. To compare sorbitol H?Breath Test with antiendomysial antibodies in the follow-up of coeliac disease to detect histological recovery Methods. A total of 38 consecutive patients with coeliac disease were studied. All underwent Sorbitol H2Breeth Test, antiendomysial and oesophagogastroduodenoscopy with multiple bioptic samples be- fore diet and then 6, 12 and 18 months after gluten-free diet. Expi- ratory samples were collected before patients drank the test solution (5 g sorbitol in 150 ml tap water] and thereafter every 30 min for 4 hours. An increase in H2 concentration of 220 ppm above fasting baseline was considered positive for sorbitol malabsorption. Antien- domysial antibodies were evaluated by the indirect immunofluorescent method. Results. Antiendomysial antibodies were positive in 32/38 patients before gluten-free diet [84.21%], while they were positive in 20/34 [54.820/o/, 2/l 6 (12.5%] and O/2 [O%] cases after 6, 12 and 18 months of gluten-free diet, respectively, no correlation being found with improvement of histological lesions (p=ns]. As far as concerns sorbitol Hz-Breath Test, maximal cut-off value