Martins AS, Santos SA, Lisboa CADS, Barros TF, Ribeiro TCM, da Costa-Ribeiro H, de Mattos ÂP, Mendes PSDA, Mendes CMC, Souza EL, Amor ALM, Soares NM, Teixeira MCA. Infectious etiology and indicators of malabsorption or intestinal injury in childhood diarrhea.
BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2024;
44:80-91. [PMID:
38648349 PMCID:
PMC11349067 DOI:
10.7705/biomedica.6913]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 02/20/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION
The multifactorial etiology of gastroenteritis emphasizes the need for different laboratory methods to identify or exclude infectious agents and evaluate the severity of diarrheal disease.
OBJECTIVE
To diagnose the infectious etiology in diarrheic children and to evaluate some fecal markers associated with intestinal integrity.
MATERIALS AND METHODS
The study group comprised 45 children with diarrheal disease, tested for enteropathogens and malabsorption markers, and 76 children whose feces were used for fat evaluation by the traditional and acid steatocrit tests.
RESULTS
We observed acute diarrhea in 80% of the children and persistent diarrhea in 20%. Of the diarrheic individuals analyzed, 40% were positive for enteropathogens, with rotavirus (13.3%) and Giardia duodenalis (11.1%) the most frequently diagnosed. Among the infected patients, occult blood was more evident in those carrying pathogenic bacteria (40%) and enteroviruses (40%), while steatorrhea was observed in infections by the protozoa G. duodenalis (35.7%). Children with diarrhea excreted significantly more lipids in feces than non-diarrheic children, as determined by the traditional (p<0.0003) and acid steatocrit (p<0.0001) methods. Moreover, the acid steatocrit method detected 16.7% more fecal fat than the traditional method.
CONCLUSIONS
Childhood diarrhea can lead to increasingly severe nutrient deficiencies. Steatorrhea is the hallmark of malabsorption, and a stool test, such as the acid steatocrit, can be routinely used as a laboratory tool for the semi-quantitative evaluation of fat malabsorption in diarrheic children.
Collapse