[Assessment of intestinal permeability using 51 CrEDTA: clinical usefulness in the detection of small bowel epithelial structural abnormalities].
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Intestinal permeability tests have been increasingly used in the clinical management of small bowel diseases. Nevertheless, the application of such tests in Brazil is still limited. In this study we report the results of the application of 51Cr-EDTA for assessment of intestinal permeability in 13 healthy volunteers, 10 control patients with miscellaneous disorders, but without evidence of small bowel involvement, 11 patients with well characterized diseases affecting the small bowel, and five patients with inflammatory conditions affecting exclusively the colon. Urinary radioactivity levels in the 24 h following the ingestion of 51Cr-EDTA, expressed as the percentage of the ingested dosis, ranged from 1.99 to 5.93% (median: 3.14%) in healthy volunteers and was not significantly different from the results obtained in control patients (range: 1.48-3.98%; median 3.32%). Based on data from these two control groups, an upper limit of the normal range was set at 5.17% (95% confidence interval). Among patients with diseases of the small bowel, results ranged from 1.58 to 14.85% (median: 8.07%) and were significantly different from those observed in the control groups. Only two out of the 11 patients in this group had abnormal results. In the group of patients with diseases of the colon, results ranged from 3.48 to 5.13% (medium: 4.54%) and were not significantly different from the results obtained in control subjects. All patients in this group had results within the normal range. Data from control subjects and patients with diseases of the small bowel were used for the calculations of sensitivity (81%), specificity (96%), as well as false-positive (4.3%) and false-negative (18.1%) rates. Taken as a whole, the results of the present study indicate that the 51Cr EDTA test of intestinal permeability is accurate and may be useful in the clinical management of small bowel diseases in Brazilian patients.
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