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Isolated Lactase Deficiency: Correlation of Laboratory Studies and Clinical Data

Isolated Lactase Deficiency: Correlation of Laboratory Studies and Clinical Data Abstract Several studies concerning isolated lactase deficiency have appeared recently.1-9 Agreement has not been reached, however, concerning the interpretation of human intestinal disaccharidase activity 10 and the lactose tolerance test.11,12 Previous studies from our laboratory reported early experience with oral tolerance tests using different amounts of lactose13 and described seven individuals with isolated lactase deficiency.14,15 Through a cooperative study involving three medical centers, we have now accumulated data on 47 individuals with this defect. The current report compares the findings in these persons with those in a group of subjects with normal lactase activity and presents our concept of the significance of an isolated lactase deficiency based on these results. Material and Methods The studies were done on 170 individuals. There were 109 males, 61 females, 145 whites, 22 Negroes, and three American Indians. The patients ranged in age from 3 to 80 years with only three References 1. Auricchio, S., et al: Isolated Intestinal Lactase Deficiency in the Adult , Lancet 2:324-326, 1963.Crossref 2. Klotz, A.P.: Intestinal Lactase Deficiency and Diarrhea in Adults , Amer J Dig Dis 9:345-354, 1964.Crossref 3. Cuatrecasas, P.; Lockwood, D.H; and Caldwell, J.R.: Lactase Deficiency in the Adult , Lancet 1:1418, 1965.Crossref 4. McMichael, H.B.; Webb, J.; and Dawson, A.M.: Lactase Deficiency in Adults , Lancet 1:717-720, 1965.Crossref 5. Dunphy, J.V., et al: Intestinal Lactase Deficiency in Adults . Gastroenterology 49:12-21, 1965. 6. Haemmerli, U.P., et al: Acquired Milk Tolerance in the Adult Caused by Lactose Malabsorption Due to a Selective Deficiency of Intestinal Lactase Activity , Amer J Med 38:7-30, 1965.Crossref 7. Peternel, W.W.: Lactose Tolerance in Relation to Intestinal Lactase Activity , Gastroenterology 48:299-306, 1965. 8. Kern, F., Jr., and Struthers, J.E., Jr.: Intestinal Lactase Deficiency and Lactose Intolerance in Adults , JAMA 195:927-930, 1966.Crossref 9. Weser, E., et al: Lactase Deficiency in Patients With the "Irritable-Colon Syndrome," New Eng J Med 273:1070-1075, 1965.Crossref 10. Sheehy, T.W., and Anderson, P.R.: Disaccharidase Activity in Normal and Diseased Small Bowel , Lancet 2:1-4, 1965.Crossref 11. Newcomer, A.D., and McGill, D.B.: Lactose Tolerance Tests in Adults With Normal Lactase Activity , Gastroenterology 50:340-346, 1966. 12. Friedland, N.: "Normal" Lactose Tolerance Test , Arch Intern Med 116:886-888, 1965.Crossref 13. Welsh, J.D.; Rohrer, G.V.; and Walker, A.: Human Intestinal Disaccharidase Activity: I. Normal Individuals , Arch Intern Med 117:488-494, 1966.Crossref 14. Welsh, J.D., et al: Human Intestinal Disaccharidase Activity: II. Diseases of the Small Intestine and Deficiency States , Arch Intern Med 117:495-503, 1966.Crossref 15. Welsh, J. D.; Shaw, R.W.; and Walker, A.: Isolated Lactase Deficiency Producing Postgastrectomy Milk Intolerance , Ann Intern Med 64:12521258, 1966.Crossref 16. Welsh. J. D.: On the Lactose Tolerance Test , Gastroenterology 51:445-446, 1966. 17. Conn, J.W., and Fajans, S.S.: The Prediabetic State , Amer J Med 31:839-850, 1961.Crossref 18. Bickel, H.: Mellituria, a Paper Chromatographic Study , J Pediat 59:641-656, 1961.Crossref 19. Weser, E., and Sleisenger, M.H.: Lactosuria and Lactase Deficiency in Adult Celiac Disease , Gastroenterology 48:571-578, 1965. 20. Baker, S.J., and Hughes, A.: Multiple-Retrieving Small-Intestinal Biopsy Tube , Lancet 2:686-687, 1960.Crossref 21. Welsh, J.D.; Rohrer, G. V.; and Porter, M.G.: The Baker-Hughes Gastrointestinal Biopsy Tube , Amer J Dig Dis 11:559-563, 1966.Crossref 22. Crosby, W.H., and Kugler, H.W.: Intraluminal Biopsy of the Small Intestine: The Intestinal Biopsy Capsule , Amer J Dig Dis 2:236-241, 1957.Crossref 23. Dahlqvist, A.: Method for Assay of Intestinal Disaccharidases , Anal Biochem 7:18-25, 1964.Crossref 24. Klein, B.; Read, P.A.; and Babson, A.L.: Rapid Method for the Quantitative Determination of Serum Alkaline Phosphatase , Clin Chem 6:269275, 1960. 25. Lowry, O.H., et al: Protein Measurement With the Folin Phenol Reagent , J Biol Chem 193: 265-275, 1951. 26. Langner, P.H., Jr., and Fies, H.L.: Capillary-Venous Differences in Blood Glucose Values During the One-Hour, Two-Dose Glucose Tolerance Test (Exton-Rose Procedure) , Amer J Clin Path 12:95-102, 1942. 27. Mosenthal, H.O., and Barry, E.: Criteria for and Interpretation of Normal Glucose Tolerance Tests , Ann Intern Med 33:1175-1194, 1950.Crossref 28. Watson, D., and Stevenson, M.E.K.: The Micro-determination of Blood Glucose , Aust J Exp Biol Med Sci 41:211-220, 1963.Crossref 29. Ruiter, J.; Weinberg, F.; and Morrison, A.: The Stability of Glucose in Serum , Clin Chem 9: 356-359, 1963. 30. Meites, S., and Bohman, N.: In Vitro Stabilization of Blood Glucose With Water , Clin Chem 9:594-599, 1963. 31. Crane, R.K.: Enzymes and Malabsorption: A Concept of Brush Border Membrane Disease , Gastroenterology 50:254-262, 1966. 32. Bayless, T.M., and Rosenweig, N.S.: A Racial Difference in Incidence of Lactase Deficiency , JAMA 197:968-972, 1966.Crossref 33. Haemmerli, U.P., and Kistler, H.: Disaccharide Malabsorption , DM (July) 1966, pp 3-51. 34. Plotkin, G.R., and Isselbacher, K.J.: Secondary Disaccharidase Deficiency in Adult Celiac Disease (Non Tropical Sprue) and Other Malabsorption States , New Eng J Med 271:1033-1037, 1964.Crossref 35. Kojecký, Z., and Matlocha, Z.: Quantitative Differences of Intestinal Disaccharidase Activity Following the Resection of Stomach , Gastroenterologia 104:343-351, 1965.Crossref 36. Townley, R.R.W.; Khaw, K.T.; and Shwachman, H.: Quantitative Assay of Disaccharidase Activities of Small Intestinal Mucosal Biopsy Specimens in Infancy and Childhood , Pediatrics 36:911-921, 1965. 37. Cook, G.C., and Kajubi, S.K.: Tribal Incidence of Lactase Deficiency in Uganda , Lancet 1: 725-729, 1966.Crossref 38. Littman, A.: Isolated Lactase Deficit in the Adult: A Present View , JAMA 195:954-955, 1966.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Isolated Lactase Deficiency: Correlation of Laboratory Studies and Clinical Data

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Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1967.00300030003003
Publisher site
See Article on Publisher Site

Abstract

Abstract Several studies concerning isolated lactase deficiency have appeared recently.1-9 Agreement has not been reached, however, concerning the interpretation of human intestinal disaccharidase activity 10 and the lactose tolerance test.11,12 Previous studies from our laboratory reported early experience with oral tolerance tests using different amounts of lactose13 and described seven individuals with isolated lactase deficiency.14,15 Through a cooperative study involving three medical centers, we have now accumulated data on 47 individuals with this defect. The current report compares the findings in these persons with those in a group of subjects with normal lactase activity and presents our concept of the significance of an isolated lactase deficiency based on these results. Material and Methods The studies were done on 170 individuals. There were 109 males, 61 females, 145 whites, 22 Negroes, and three American Indians. The patients ranged in age from 3 to 80 years with only three References 1. Auricchio, S., et al: Isolated Intestinal Lactase Deficiency in the Adult , Lancet 2:324-326, 1963.Crossref 2. Klotz, A.P.: Intestinal Lactase Deficiency and Diarrhea in Adults , Amer J Dig Dis 9:345-354, 1964.Crossref 3. Cuatrecasas, P.; Lockwood, D.H; and Caldwell, J.R.: Lactase Deficiency in the Adult , Lancet 1:1418, 1965.Crossref 4. McMichael, H.B.; Webb, J.; and Dawson, A.M.: Lactase Deficiency in Adults , Lancet 1:717-720, 1965.Crossref 5. Dunphy, J.V., et al: Intestinal Lactase Deficiency in Adults . Gastroenterology 49:12-21, 1965. 6. Haemmerli, U.P., et al: Acquired Milk Tolerance in the Adult Caused by Lactose Malabsorption Due to a Selective Deficiency of Intestinal Lactase Activity , Amer J Med 38:7-30, 1965.Crossref 7. Peternel, W.W.: Lactose Tolerance in Relation to Intestinal Lactase Activity , Gastroenterology 48:299-306, 1965. 8. Kern, F., Jr., and Struthers, J.E., Jr.: Intestinal Lactase Deficiency and Lactose Intolerance in Adults , JAMA 195:927-930, 1966.Crossref 9. Weser, E., et al: Lactase Deficiency in Patients With the "Irritable-Colon Syndrome," New Eng J Med 273:1070-1075, 1965.Crossref 10. Sheehy, T.W., and Anderson, P.R.: Disaccharidase Activity in Normal and Diseased Small Bowel , Lancet 2:1-4, 1965.Crossref 11. Newcomer, A.D., and McGill, D.B.: Lactose Tolerance Tests in Adults With Normal Lactase Activity , Gastroenterology 50:340-346, 1966. 12. Friedland, N.: "Normal" Lactose Tolerance Test , Arch Intern Med 116:886-888, 1965.Crossref 13. Welsh, J.D.; Rohrer, G.V.; and Walker, A.: Human Intestinal Disaccharidase Activity: I. Normal Individuals , Arch Intern Med 117:488-494, 1966.Crossref 14. Welsh, J.D., et al: Human Intestinal Disaccharidase Activity: II. Diseases of the Small Intestine and Deficiency States , Arch Intern Med 117:495-503, 1966.Crossref 15. Welsh, J. D.; Shaw, R.W.; and Walker, A.: Isolated Lactase Deficiency Producing Postgastrectomy Milk Intolerance , Ann Intern Med 64:12521258, 1966.Crossref 16. Welsh. J. D.: On the Lactose Tolerance Test , Gastroenterology 51:445-446, 1966. 17. Conn, J.W., and Fajans, S.S.: The Prediabetic State , Amer J Med 31:839-850, 1961.Crossref 18. Bickel, H.: Mellituria, a Paper Chromatographic Study , J Pediat 59:641-656, 1961.Crossref 19. Weser, E., and Sleisenger, M.H.: Lactosuria and Lactase Deficiency in Adult Celiac Disease , Gastroenterology 48:571-578, 1965. 20. Baker, S.J., and Hughes, A.: Multiple-Retrieving Small-Intestinal Biopsy Tube , Lancet 2:686-687, 1960.Crossref 21. Welsh, J.D.; Rohrer, G. V.; and Porter, M.G.: The Baker-Hughes Gastrointestinal Biopsy Tube , Amer J Dig Dis 11:559-563, 1966.Crossref 22. Crosby, W.H., and Kugler, H.W.: Intraluminal Biopsy of the Small Intestine: The Intestinal Biopsy Capsule , Amer J Dig Dis 2:236-241, 1957.Crossref 23. Dahlqvist, A.: Method for Assay of Intestinal Disaccharidases , Anal Biochem 7:18-25, 1964.Crossref 24. Klein, B.; Read, P.A.; and Babson, A.L.: Rapid Method for the Quantitative Determination of Serum Alkaline Phosphatase , Clin Chem 6:269275, 1960. 25. Lowry, O.H., et al: Protein Measurement With the Folin Phenol Reagent , J Biol Chem 193: 265-275, 1951. 26. Langner, P.H., Jr., and Fies, H.L.: Capillary-Venous Differences in Blood Glucose Values During the One-Hour, Two-Dose Glucose Tolerance Test (Exton-Rose Procedure) , Amer J Clin Path 12:95-102, 1942. 27. Mosenthal, H.O., and Barry, E.: Criteria for and Interpretation of Normal Glucose Tolerance Tests , Ann Intern Med 33:1175-1194, 1950.Crossref 28. Watson, D., and Stevenson, M.E.K.: The Micro-determination of Blood Glucose , Aust J Exp Biol Med Sci 41:211-220, 1963.Crossref 29. Ruiter, J.; Weinberg, F.; and Morrison, A.: The Stability of Glucose in Serum , Clin Chem 9: 356-359, 1963. 30. Meites, S., and Bohman, N.: In Vitro Stabilization of Blood Glucose With Water , Clin Chem 9:594-599, 1963. 31. Crane, R.K.: Enzymes and Malabsorption: A Concept of Brush Border Membrane Disease , Gastroenterology 50:254-262, 1966. 32. Bayless, T.M., and Rosenweig, N.S.: A Racial Difference in Incidence of Lactase Deficiency , JAMA 197:968-972, 1966.Crossref 33. Haemmerli, U.P., and Kistler, H.: Disaccharide Malabsorption , DM (July) 1966, pp 3-51. 34. Plotkin, G.R., and Isselbacher, K.J.: Secondary Disaccharidase Deficiency in Adult Celiac Disease (Non Tropical Sprue) and Other Malabsorption States , New Eng J Med 271:1033-1037, 1964.Crossref 35. Kojecký, Z., and Matlocha, Z.: Quantitative Differences of Intestinal Disaccharidase Activity Following the Resection of Stomach , Gastroenterologia 104:343-351, 1965.Crossref 36. Townley, R.R.W.; Khaw, K.T.; and Shwachman, H.: Quantitative Assay of Disaccharidase Activities of Small Intestinal Mucosal Biopsy Specimens in Infancy and Childhood , Pediatrics 36:911-921, 1965. 37. Cook, G.C., and Kajubi, S.K.: Tribal Incidence of Lactase Deficiency in Uganda , Lancet 1: 725-729, 1966.Crossref 38. Littman, A.: Isolated Lactase Deficit in the Adult: A Present View , JAMA 195:954-955, 1966.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Sep 1, 1967

References