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. 1990 Aug;31(8):879–882. doi: 10.1136/gut.31.8.879

Jejunal bacterial overgrowth and intestinal permeability in children with immunodeficiency syndromes.

C Pignata 1, G Budillon 1, G Monaco 1, E Nani 1, R Cuomo 1, G Parrilli 1, F Ciccimarra 1
PMCID: PMC1378614  PMID: 2387510

Abstract

Seventeen paediatric patients with immunodeficiency syndromes (10 with selective IgA deficiency, four with panhypogammaglobulinaemia, and three with selective T cell deficiency) were investigated for bacterial overgrowth of the small intestine and gut permeability to macromolecules. Five of 12 patients showed viable bacterial counts of more than 2 x 10(5)/ml in jejunal fluid. Bacterial overgrowth was also confirmed indirectly by breath hydrogen determination, which was higher than 10 ppm in four of the five patients with positive jejunal culture. Gut permeability to lactulose and L-rhamnose was abnormal in 16 of the 17 immunodeficient patients, who also had higher mean urinary excretion ratios than control subjects-mean (SD) values were 0.216 (0.160) and 0.029 (0.002), respectively. These studies indicate that bacterial overgrowth of the small intestine is a common feature in immunodeficient patients, regardless of the immunological abnormality. Moreover, these patients have an increased gut permeability to macromolecules.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bourrillon A., Lambert-Zechovsky N., Beaufils F., Lejeune C., Bingen E., Blum C., Mathieu H. Antibiothérapie et pullulation microbienne intestinale et risque infectieux chez l'enfant. Arch Fr Pediatr. 1978 Dec;35(10 Suppl):23–37. [PubMed] [Google Scholar]
  2. Buckley R. H., Fiscus S. A. Serum IgD and IgE concentrations in immunodeficiency diseases. J Clin Invest. 1975 Jan;55(1):157–165. doi: 10.1172/JCI107906. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Budillon G., Parrilli G., Pacella M., Cuomo R., Menzies I. S. Investigation of intestine and liver function in cirrhosis using combined sugar oral loads. J Hepatol. 1985;1(5):513–524. doi: 10.1016/s0168-8278(85)80749-2. [DOI] [PubMed] [Google Scholar]
  4. Cunningham-Rundles C., Brandeis W. E., Good R. A., Day N. K. Bovine antigens and the formation of circulating immune complexes in selective immunoglobulin A deficiency. J Clin Invest. 1979 Jul;64(1):272–279. doi: 10.1172/JCI109448. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cunningham-Rundles C., Carr R. I., Good R. A. Dietary protein antigenemia in humoral immunodeficiency. Correlation with splenomegaly. Am J Med. 1984 Feb;76(2):181–185. doi: 10.1016/0002-9343(84)90771-x. [DOI] [PubMed] [Google Scholar]
  6. Gracey M. The contaminated small bowel syndrome: pathogenesis, diagnosis, and treatment. Am J Clin Nutr. 1979 Jan;32(1):234–243. doi: 10.1093/ajcn/32.1.234. [DOI] [PubMed] [Google Scholar]
  7. Horowitz S., Lorenzsonn V. W., Olsen W. A., Albrecht R., Hong R. Small intestinal disease in T cell deficiency. J Pediatr. 1974 Oct;85(4):457–462. doi: 10.1016/s0022-3476(74)80444-0. [DOI] [PubMed] [Google Scholar]
  8. Klipstein F. A. Jejunal bacterial overgrowth in acute and persistent infectious diarrhea. J Pediatr Gastroenterol Nutr. 1986 Sep-Oct;5(5):683–687. [PubMed] [Google Scholar]
  9. Leblanc A., Lambert-Zechovsky N., Bingen E., Proux M. C., Odièvre M. Bacteriological analysis of jejunostomy fluid after surgery for extrahepatic biliary atresia. J Pediatr Gastroenterol Nutr. 1983 May;2(2):307–310. [PubMed] [Google Scholar]
  10. Maxton D. G., Bjarnason I., Reynolds A. P., Catt S. D., Peters T. J., Menzies I. S. Lactulose, 51Cr-labelled ethylenediaminetetra-acetate, L-rhamnose and polyethyleneglycol 400 [corrected] as probe markers for assessment in vivo of human intestinal permeability. Clin Sci (Lond) 1986 Jul;71(1):71–80. doi: 10.1042/cs0710071. [DOI] [PubMed] [Google Scholar]
  11. Menzies I. S., Laker M. F., Pounder R., Bull J., Heyer S., Wheeler P. G., Creamer B. Abnormal intestinal permeability to sugars in villous atrophy. Lancet. 1979 Nov 24;2(8152):1107–1109. doi: 10.1016/s0140-6736(79)92507-8. [DOI] [PubMed] [Google Scholar]
  12. Menzies I. S. Quantitative estimation of sugars in blood and urine by paper chromatography using direct densitometry. J Chromatogr. 1973 Jun 27;81(1):109–127. doi: 10.1016/s0021-9673(01)82322-0. [DOI] [PubMed] [Google Scholar]
  13. Paganelli R., Levinsky R. J., Brostoff J., Wraith D. G. Immune complexes containing food proteins in normal and atopic subjects after oral challenge and effect of sodium cromoglycate on antigen absorption. Lancet. 1979 Jun 16;1(8129):1270–1272. doi: 10.1016/s0140-6736(79)92230-x. [DOI] [PubMed] [Google Scholar]
  14. Parrilli G., Cuomo R., Nardone G., Maio G., Izzo C. M., Budillon G. Investigation of intestine function during acute viral hepatitis using combined sugar oral loads. Gut. 1987 Nov;28(11):1439–1444. doi: 10.1136/gut.28.11.1439. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Perman J. A., Modler S., Barr R. G., Rosenthal P. Fasting breath hydrogen concentration: normal values and clinical application. Gastroenterology. 1984 Dec;87(6):1358–1363. [PubMed] [Google Scholar]
  16. Primary immunodeficiency diseases. Report prepared for the WHO by a scientific group on immunodeficiency. Clin Immunol Immunopathol. 1983 Sep;28(3):450–475. [PubMed] [Google Scholar]
  17. Rosen F. S., Cooper M. D., Wedgwood R. J. The primary immunodeficiencies (1). N Engl J Med. 1984 Jul 26;311(4):235–242. doi: 10.1056/NEJM198407263110406. [DOI] [PubMed] [Google Scholar]
  18. Rosen F. S., Cooper M. D., Wedgwood R. J. The primary immunodeficiencies. (2). N Engl J Med. 1984 Aug 2;311(5):300–310. doi: 10.1056/NEJM198408023110506. [DOI] [PubMed] [Google Scholar]
  19. Rosen F. S., Janeway C. A. The gamma globulins. 3. The antibody deficiency syndromes. N Engl J Med. 1966 Sep 29;275(13):709–contd. doi: 10.1056/NEJM196609292751307. [DOI] [PubMed] [Google Scholar]
  20. Saulsbury F. T., Winkelstein J. A., Yolken R. H. Chronic rotavirus infection in immunodeficiency. J Pediatr. 1980 Jul;97(1):61–65. doi: 10.1016/s0022-3476(80)80131-4. [DOI] [PubMed] [Google Scholar]
  21. Walker W. A., Hong R. Immunology of the gastrointestinal tract. II. J Pediatr. 1973 Nov;83(5):711–720. doi: 10.1016/s0022-3476(73)80361-0. [DOI] [PubMed] [Google Scholar]
  22. Webster A. D. The gut and immunodeficiency disorders. Clin Gastroenterol. 1976 May;5(2):323–340. [PubMed] [Google Scholar]

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