Clinical forms of lactase deficiency in children
Background. Lactase deficiency (LD) is the most common pathology of small intestine characterized by the development of maldigestion and malabsorbtion syndromes associated with the absence or lack of the enzyme lactase activity. Objective: to study the features of various LD clinical forms in children. Materials and methods. We have examined 40 children (21 boys and 19 girls) of different age groups diagnosed with lactate deficiency. The following studies were conducted: stool analysis, pH determination, total carbohydrate content, lactose load, and urinary lactose content. The probability assessment was performed using Student’s t-test. Results. Four clinical groups have been identified depending on the form of LD: the first group — LD with complete absence of the enzyme (alactasia, 4 persons), the second — LD with partial deficiency of the enzyme (hypolactasia, 10 individuals), the third — LD with lactosuria (4 patients), the fourth — transient LD (22 people). The clinical picture manifested by liquid (100 %), foamy (83.3 %), with acidic smell (83.3 %) feces. One-third of children with LD experienced regurgitation, 75.0 % — abdominal colic. All children had weight deficit and deficiency anemia. Conclusions. Transient (secondary) lactase deficiency is most common, it occurs in mild form in children of different age categories. Alactasia is typical for children under 1 year of age, it occurs with significant clinical signs against a background of deficiency of weight deficit and anemia. Hypolactasia occurs with mild clinical symptoms. LN with lactosuria is characteristic of premature infants.
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