Sucrosemia in Untreated Celiac Disease (A Potential Screening Test)

During studies to develop serum tests of smallintestinal permeability, we detected an unidentifieddisaccharide in HPLC traces of sera from untreatedceliacs. This present study aimed to identify thedisaccharide and determine whether the presence of thedisaccharide in the serum after an oral challenge hadpotential as a simple screening test for celiac disease.The disaccharide was identified as sucrose by incubation studies of sera with disaccharidases. Twentyuntreated celiacs, 15 treated celiacs, and 20 normal ordyspeptic controls were studied for the presence ofsucrose in their serum after an oral load (8 g). The results in celiacs were compared with thepresence of serum IgA endomysial antibodies. The 10normal controls were also given a larger sucrosechallenge (50 g). Ten of the untreated celiacs and 10controls had their brush border disaccharidaseactivities measured. Sucrose eluted in the same positionas the unidentified disaccharide in the HPLC trace andthe latter could be removed by incubation with sucrase. All untreated celiacs but none of the treatedceliacs had sucrose in their serum after the 8-g oralchallenge. None of the controls had sucrose in theirserum after the 8-g or 50-g challenges. Three untreated celiacs were IgA endomysial antibody negativeas were all the treated cases. Brush border sucraseactivity was low in untreated celiac disease. Thepresence of sucrose in the serum after an oral loadshows promise as a noninvasive test for celiacdisease.