Frequency and Clinical Characteristics of Abnormal Sucrase Enzyme Activity in Pediatric Patients
To determine the frequency and clinical characteristics of abnormal sucrase activity in pediatric patients undergoing esophagogastroduodenoscopy (EGD) and disaccharidase analysis. A retrospective chart review was performed for pediatric patients who underwent EGD and duodenal biopsy with disaccharidase analysis between May 2017 to May 2018 at Children’s Hospital, Los Angeles. Statistical analyses examined the associations between disaccharide activity and clinical characteristics, including gastrointestinal symptoms, existing primary gastrointestinal disease, and medication use prior to biopsy. A total of 473 biopsies from patients aged 4 months to 21 years were analyzed. The frequency of sucrase deficiency (< 25 μg/mL/min) was 13.95%. The frequency of moderate normal sucrase activity (25-50 μg/mL/min) was 41.44%. Of all the biopsies, 60.61% had demonstrated normal duodenal histology, and 39.39% had shown abnormal histology. Of moderate normal activity biopsies, 72.96% had shown normal histology and 27.04% had demonstrated abnormal histology. Abdominal pain (62.8%), diarrhea (28.1%), and constipation (22.5%) were commonly reported among patients with moderate normal activity. Sucrase deficiency is more prevalent than previously understood and may be an underrecognized etiology of gastrointestinal symptoms in pediatric patients. A high frequency of moderate normal sucrase activity was identified, but the clinical significance remains unclear. No significant differences in symptoms were identified between patients with or without sucrase deficiency undergoing EGD. A high frequency of abdominal pain, diarrhea, and constipation was identified in patients undergoing EGD and disaccharidase analysis. Diarrhea was significantly associated with abnormal sucrase activity.
