[Measurement of intestinal permeability to sugars: application in the diagnosis of celiac disease and cow's milk protein enteropathy].

Intestinal permeability to macromolecules was studied by measuring differential urinary elimination of two orally ingested non-metabolizable sugars of different molecular size, mannitol and lactulose. In 25 control children, mannitol and lactulose urinary elimination were 16.30 +/- 5.77% and 0.33 +/- 0.10% of ingested dose, respectively, with a mean lactulose/mannitol (M/M) urinary ratio of 2.73 +/- 0.70%. In 7 celiac children, L/M ratio exhibited a significant rise: 8.53 +/- 2.54% (p less than 0.001). In 7 children with cow's milk sensitive enteropathy under exclusion diet, L/M ratio was normal in fasting condition: 2.63 +/- 1.28% and raised significantly during provocation test with milk: 7.22 +/- 3.88% (p less than 0.01). Intestinal permeability test is a reliable index of villous atrophy and cow's milk sensitive enteropathy.