Lactose intolerance in children with protein-energy malnutrition

Lactose tolerance test was performed on 40 children suffering from protein energy malnutrition (PEM) and 10 control children. Lactose intolerance was documented in two cases of kwashiorkor by a flat curve, diarrhea, low stool pH, and presence of reducing substances in the stools. Of 38 marasmic children, four had a maximum blood sugar rise below 20–30 mg/dl, but they did not exhibit any other signs of intolerance. It is suggested that marasmic infants can adequately hydrolyse lactose in milk.     

Lactose intolerance associated with cataracts

A 50-day-old boy with severe lactose intolerance is described. In addition to vomiting, failure to thrive, dehydration, metabolic acidosis and amino aciduria, bilateral cataracts were also found.At three months of age, a computerized axial tomography scan and an electroencephalogram were abnormal, and myoclonic spasms began at the age of seven months.     

新生儿非感染性腹泻乳糖不耐受发生情况调查

目的 观察新生儿非感染性腹泻时乳糖不耐受的发生状况及其与腹泻的关系;评价大便pH 值、尿半乳糖测定对新生儿乳糖酶缺乏的诊断意义.方法 选取2012 年10 月至2015 年6 月70 例发生非感染性腹泻的住院新生儿为腹泻组,同期选取162 例无腹泻的住院新生儿为无腹泻组.采用试纸法测定两组大便pH 值;半乳糖氧化酶法检测尿半乳糖,以尿半乳糖阳性诊断为乳糖酶缺乏,有乳糖酶缺乏的腹泻诊断为乳糖不耐受.根据尿半乳糖检测结果,将69 例行尿半乳糖测定的腹泻组患儿分为乳糖不耐受组(n=45)和乳糖耐受组(n=24),比较两组新生儿治疗后的情况.腹泻患儿出院后3 个月进行随访.结果 腹泻组与非腹泻组新生儿大便pH 值及尿半乳糖阳性率(65% vs 54%)比较差异均无统计学意义(P>0.05).乳糖不耐受和耐受组腹泻患儿大便pH值比较差异无统计学意义(P>0.05),乳糖不耐受患儿大便恢复时间比耐受组患儿长(P结论 新生儿乳糖酶缺乏发生率高,易发生乳糖不耐受性腹泻.大便pH 值测定对判断腹泻患儿乳糖不耐受意义不大.     

Lactose intolerance in infants, children, and adolescents

The American Academy of Pediatrics Committee on Nutrition presents an updated review of lactose intolerance in infants, children, and adolescents. Differences between primary, secondary, congenital, and developmental lactase deficiency that may result in lactose intolerance are discussed. Children with suspected lactose intolerance can be assessed clinically by dietary lactose elimination or by tests including noninvasive hydrogen breath testing or invasive intestinal biopsy determination of lactase (and other disaccharidase) concentrations. Treatment consists of use of lactase-treated dairy products or oral lactase supplementation, limitation of lactose-containing foods, or dairy elimination. The American Academy of Pediatrics supports use of dairy foods as an important source of calcium for bone mineral health and of other nutrients that facilitate growth in children and adolescents. If dairy products are eliminated, other dietary sources of calcium or calcium supplements need to be provided.     

Lactose and milk intolerance in recurrent abdominal pain of childhood

Lactose tolerance test (LTT) was performed in 70 children with idiopathic recurrent abdominal pain (IRAP) and 50 matched controls. The prevalence of lactose malabsorption in the IRAP patients (47.1%) was significantly higher than in controls (18%). When milk was withheld fora 4 week period, 33% (11/33) of lactose malabsorbers and 16.2% (6/37) of lactose absorbers were relieved of their symptoms, the difference being insignificant. The limitations of standard oral lactose tolerance test are discussed.