Intestinal clearance of α1-antitrypsin

Florent, C.; L'Hirondel, Ch.; Desmazures, C; Aymes, C; Bernier, J J

doi:10.1016/0016-5085(81)90506-0

Cited by 177 publications

(15 citation statements)

References 9 publications

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“…Furthermore, no significant correlation was found between fecal al-AT values and other parameters of active inflammatory bowel disease, except for an inverse correlation with hematocrit for the relapse group. With fcw exceptions (7,8), the majority of other studies also failed to show significant correlation between disease localization, serum inflammatory parameters, clinical or endoscopic activity indices of CD, and fecal a l -A T values (3,6,(9)(10)(11)(12)(13)(14)(15)(16). Nevertheless, we did observe that fecal a 1-AT levels were substantially elevated in patients with CD, in comparison to other diarrheal diseases, or to healthy controls, as previously noted by others (17)(18)(19).…”

Section: Discussionsupporting

confidence: 83%

Fecal α1-antitrypsin: A marker of intestinal versus systemic inflammation in pediatric Crohn's disease?

1996

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: Growth failure and malnutrition are major concerns in pediatric patients with frequent relapses of Crohn's disease (CD). In search of an early, noninvasive marker of relapse, we prospectively examined the relationship between levels of fecal α1-antitrypsin (α1-AT) in comparison with other known inflammatory parameters and disease activity using a pediatric CD Activity Index (P-CDAI), as well as in relation to growth. Forty-two pediatric patients (29 M, 13 F, 7-16 years old, mean 12.8 years) with ileal or ileocolonic CD were prospectively examined at 4 monthly intervals over a 1 year period. Median (interquartile range) fecal α1-AT values did not differ between children in clinical relapse (P-CDAI > 150, n = 10) compared with CD patients (n = 42) with quiescent disease [1.84 (3.67) mg/g versus 1.55 (3.97) mg/g, respectively, p = ns]. However, children with growth failure (n = 14) had a significantly higher fecal α1-AT [3.63 (5.65) mg/g] despite clinical remission [median P-CDAI 22 (72.5)] compared with those with normal growth [1.41 (1.66) mg/g, p = 0.02]. Very high fecal α1-AT levels (>4 mg/g) were not associated with clinically active disease [median P-CDAI 23 (71.5)]. Overall however, levels in CD were significantly higher than that of 17 pediatric control patients with diarrheal disorders unrelated to IBD [0.98 (1.21), p < 0.05]. Fecal α1-AT seems therefore not to be a reliable marker of clinically evident disease activity, but was best correlated with chronic malnutrition and subclinical disease activity.

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Section: Discussionsupporting

confidence: 83%

Fecal α1-antitrypsin: A marker of intestinal versus systemic inflammation in pediatric Crohn's disease?

1996

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“…Results from this small series suggest that fecal alpha 1-antitrypsin clearance is a non invasive, inexpensive, sensitive marker of asymptomatic recurrence in CD patients who are under regular supervision after surgery [19]. The role of fecal alpha 1-antitrypsin clearance in assessing the presence and severity of CD lesions has been suggested by several studies [17,18]. However, the worldwide use of this parameter at this purpose is highly limited by difficulties and unpleasant modalities of measurement as also by its low specificity for diagnosing CD lesions.…”

Section: Faecal Alpha 1-antitrypsin Clearance (Faecal α1aat-cl)mentioning

confidence: 74%

“…Faecal alpha 1-antitrypsin faecal clearance is an indicator of protein loss and increases during active inflammation. Higher values have been reported in patients with CD [17,18]. On the basis of this observation, a prospective longitudinal study evaluated the usefulness of faecal α1antitrypsin clearance in the early detection of postoperative asymptomatic CD recurrence [19].…”

Section: Faecal Alpha 1-antitrypsin Clearance (Faecal α1aat-cl)mentioning

confidence: 96%

Non-invasive techniques for assessing postoperative recurrence in Crohn's disease

Biancone¹,

Onali²,

Calabrese³

et al. 2008

Digestive and Liver Disease

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“…Other symptoms may be present in case of complications, including recurrent or opportunistic infections [ 4 ], deficient osteomalacia [ 5 ], as well as cutaneous lymphangiectasia [ 6 ]. Biologically, as a result of lymphatic leakage, lymphopenia, hypogammaglobulinemia, hypoproteinemia , and hypoalbuminemia are almost constant [ 7 ], the high clearance of α-1 antitrypsin in the stool is important for the diagnosis [ 8 ]. The other biomarkers are mainly a malabsorption syndrome, a decrease in the level of fat-soluble vitamins, hypocalcemia, hypolipidemia and an anemia explained by a martial or vitamins B9 or B12 deficiency [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Complicated primary intestinal lymphangiectasia (Waldmann's disease) in a child successfully treated with octreotide: A case report from a low-resource setting

Haddar

Sbia

Rkain

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction and importance The primary intestinal lymphangiectasia is a rare exudative enteropathy of unknown etiology that affects the lymphatic system. It causes lymphedema and malabsorption syndrome by the escape of the lymph and its elements into the intestinal lumen. Case presentation A female patient, diagnosed at the age of 11 with Waldmann's disease, has initially manifested chronic diarrhea with a stature-ponderal delay at the age of 6 months old; she was treated for a long time as celiac disease patient. Edematous syndrome, chronic diarrhea, staturo-ponderal delay and asymmetric lymphedema of the upper limb are the main clinical symptoms in this case. In addition, the exclusion of secondary intestinal lymphangiectasia was important for the diagnosis. Before and during her follow-up, the patient presented two complications of the disease: warts and osteomalacia. The patient did not respond to treatment with the low-fat diet; therefore, the need to add treatment with octreotide was necessary, which has given quite pleasant results. Octreotide was the therapeutic choice to treat the patient as she was resistant to the appropriate regimen with clinical improvement; nevertheless, certain biological elements of lymphatic leakage persisted. Discussion Waldmann's disease is rare. It can be responsible, besides the typical signs, for complications including warts and osteomalacia. The histopathological study of intestinal biopsies may be normal if lymphangiectasias are localized. The treatment is based on a nutritional diet associated with octreotide. During the patient's follow-up, the evolution after almost two years of the introduction of octreotide compared to the diet alone showed improved outcomes. Conclusion The treatment of Waldmann's disease is based on an adapted diet and octreotide. This case highlighted the importance of the long term follow-up in this disease.

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Intestinal clearance of α1-antitrypsin

Cited by 177 publications

References 9 publications

Fecal α1-antitrypsin: A marker of intestinal versus systemic inflammation in pediatric Crohn's disease?

Fecal α1-antitrypsin: A marker of intestinal versus systemic inflammation in pediatric Crohn's disease?

Non-invasive techniques for assessing postoperative recurrence in Crohn's disease

Complicated primary intestinal lymphangiectasia (Waldmann's disease) in a child successfully treated with octreotide: A case report from a low-resource setting

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