Fecal alpha-1 antitrypsin concentration in protein-losing enteropathies caused by Rotavirus and enteropathogenic bacteria infection
Keywords:
alpha 1-antitrypsin, protein-losing enteropathies, diarrhea
Abstract
Background An increase in protein loss through the intestinallumen is commonly found in children with intestinal inflammation. Measurement of fecal alpha-1 antitrypsin (FAA T) concentration has been used to detect the loss of protein through the digestive system. FAAT concentration increases in diarrhea patients due to Rotavirus, Adenovirus, Shigella, Enterotoxigenic E. coli (ETEC), and Salmonella infection.
Objective To determine the relationship between types of
pathogen, acute diarrhea, and alpha-1 antitrypsin concentration
in children with acute diarrhea caused by Rotavirus and
enteropathogenic infection.
Methods Descriptive statistics and proportion difference between
the two non-related groups were used to assess the proportion of
protein-losing enteropathy (PLE) in children with acute diarrhea
and was analyzed using chi square test.
Results In this study, PLE group comprised 25% (24/95) subjects
without unknown cause of diarrhea, 50% (4 7 /95) had one type
of pathogen, and in 23% (22/95) subjects had 2 or more types of pathogens. The most common pathogen found in PLE group was Rotavirus, found in67 (53%) subjects and E. coli in 41 (33%) subjects. In non-PLE group, we also found similar pathogen pattern. The mean alpha-1 antitrypsin (AAT) concentration in acute diarrhea group due to Rotavirus infection was significantly higher (P= 0.003) compared to acute diarrhea groups caused by non-Rotavirus infection. The mean AAT concentration in acute diarrhea group due to E. coli infection did not differ significantly (P= 0.735) compared to acute diarrhea group caused by non-E. coli infection.
Conclusion Rotavirus was a more significant cause of PLE
compared to E.coli.
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Burtis CA, Ashwood ER, Bruns DE, editors. Tietz textbook
of clinical chemistry and molecular diagnostics. 4'h ed. St.
Louis: Elsevier Saunders, 1999; p. 1849-89.
32. Conway SP, Ireson A. Acute gastroenteritis in well nourished
infants : comparison of four feeding regiments. Arch Dish
Child. 1989;64:87-91.
kematian bayi dan anak balita di Indonesia: 1992-2001.
Buletin Panel Kesehatan. 2003;31:48-59.
2. Suryaatmaja S. Gastroenterologi anak. 1st ed. Jakarta: Sagung Seto, 2005; p.l-28.
3. Sunoto. Pendekatan diagnostik - etiologik diare akut.
Penanganan mutakhir beberapa penyakit gastrointestinal
anak. Pendidikan tambahan berkala ilmu kesehatan anak.
Jakarta; 1988.
4. Sunoto. Diare akut. In: Markum A, Ismael S, Alatas H,
Akib A, Firmansyah A, Sastroasmoro S, editors. Buku ajar
Ilmu Kesehatan Anak. 1 sr ed. Jakarta : Balai Penerbit FKUI,
199l;p.446-8.
5. Noerasid, H. Gastroenteritis akut. In: Suharyono, Boediarso
A, Halimun EM, editors. Gastroenterologi anak praktis. Jrd
edition. Jakarta: Balai Penerbit FKUI, 1999; p.51-76.
6. Greene HL, Hazlett D, Demaree R. Relationship in two
infants during total parenteral alimentation for diarrhea .
Am] ClinNutr. 1976;29:125-6.
7. Ariyani A. Gambaran diare akut serta hubungannya
dengan gejala yang ditemukan pada anak 0-2 tahun yang
dirawat di Departemen Ilmu Kesehatan Anak, Fakultas
Kedokteran Universitas Indonesia, Rumah Sakit Dr. Cipto
Mangunkusumo, Jakarta periode September 1996-Januari
1997. [Thesis]. Jakarta: Universitas Indonesia; 1998.
8. Murphy MS. Guidelines for managing acute gastroenteritis
based on a systematic review of published study. Arch Dis
Child. 1998;79:279-84.
9. BoshuizenJ, Walker SmithJA. Diseases of the small intestine
in childhood. In: Walker WA, Goulet OJ, Kleinmann RE,
Sanderson IR, Sherman PM, Shneider BL, editors. Walker's
pediatric gastrointestinal disease: pathophysiology, diagnosis,
management. 4rh ed. Ontario: BC Decker Publisher Inc,
2005;p.380-l.
10. Noerasid H, Suraatmadja S, Asnil PO. Gastroenteritis akut.
In: Gastroenteritis Anak Praktis. Jakarta: Balai Penerbit
FKUI, 1988; p.51-76.
11. Cook GC. The small intestine and its role in chronic diarrheal
disease in the tropics. In: Gracey M, editors. Diarrhea. 1 sr ed.
Florida: CRC Press Inc, 1991; p. 127-62.
12. Wershil BK. Protein-Losing Enteropathy[homepage on the
internet]. 2006. [cited on 2007 July 16]. Available from:
http://www.emedicine.com/ped/topic 1909.htm
13. Sarker SA, Wahed MA, Rahman MM, Alam AN, Islam A,
Jahan F. Persistent PLEin post measles diarrhea. Arch. Dis
Child. 1986;61:739-43.
14. Frye RE, Tamer MA. Diarrhea[homepage on the internet].
[cited on 2007, August 7]. Available from : http://www.
emedicine.com/ ped/topic583.-htm.
15. Fontana M, Zuin G, Galli L, Paccagnini S, Villa M, Loguercio
L. Fecal alpha-1-antitrypsin excretion in acute diarrhea:
relationship with causative pathogens. Helv Paediatr Acta.
1988;43:211-8.
16. Martinez H, Tomkins AM. Nutritional management of
diarrhea [homepage on the internet]. [cited on 2007,
August 7].Available from http://www.unu.edu/unupress/
food/8F164e/8F164EOb.htm.
17. Maki M, Harmoinen A, Vesikari T, Visakorpi JK. Faecal
excretion of alpha-1-antitrypsin in acute diarrhoea. Arch
Dis Child. 1982;57:154-6.
18. Anonymous. al-Antitrypsin ELISA kit: for the in vitro
determination of alpha-1 antitrypsin in serum and stool.
Germany: Immundiagnostik; 2006.
19. Anonymous. Leaflet Rotavirus. BioMerieux. Germany. 2006.
20. Jawetz E, Melnick], Adelberg E. Adenovirus. In: Brooks GF,
Butel JS, Morse SA, editors. Jawetz, Melnick, Adelberg's
Medical Microbiology. 23th ed. Boston: Mc-Graw Hill
Companies, 2004; p. 420-7.
21. Sunoto, Sutoto, Suparto P, Sunarto Y, Ismail R. Epidemiologi
diarrhea. In: Buku ajar diarrhea. Jakarta: Ditjen PPM & PLP
Dep Kes, 1990; p. 5-9.
22. Anonymous. Alpha-1-antitrypsin stool, USCD Lab/
University of California, San Diego; ARUP Laboratories,
Westcliff Laboratories [homepage on the internet]. [cited
on 2008, April 7]. Available from: hhtp:/health. uscd.edu/
labref /P240.html on.
23. Tjitrasari T, Firmansyah A, Chair I. Clinical manifestations
of Rotavirus diarrhea in the outpatient clinic of Cipto
Mangunkusumo Hospital, Jakarta. Pediatr Indones.
2005;45:69-75.
24. Hegar B, Kadim M, Pasaribu A. Karakteristik mikroorganisme
saluran cerna pada anak dengan diare akut. Maj Kedokt
lndon. 2004;54:367-71.
25. Setiyadi S. Prevalensi infeksi Rotavirus pada anak penderita
diare akut usia 1-60 bulan di Puskesmas kota Bandung.
[Thesis]. Bandung: University of Padjadjaran; 2003.
26. WHO Scientific Working Group. Escherichia coli diarrhoea.
Bulletin of WHO. 1980;58:23-36.
2 7. Levine MM. Escherichia coli that cause diarrhea. J Infect
Dis. 1987;155(3):377-85.
28. Paniagua M, Espinoza F, Ringman M, Reizenstein E,
Svennerholm AM, Hallander H. Analysis of incidence
of infection with enterotoxigenic escherichia coli in a
prospective cohort study of infant diarrhea in Nicaragua. J
Clin Microbial. 1997;35:1404-10.
29. Weizman Z, Binsztok M, Fraser D, Deckelbaum R, Granot
E. Intestinal protein loss in acute and persistent diarrhea of
early childhood. J Clin Gastroenterol. 2002;34:427-9.
30. Darani HY, Rahimian G, Nafisi M, Amini SA, Najafi A,
Sarafpoor M. Unsuitability of fecal alpha-1 antitrypsin as
a marker for differentiation of microbial and nonmicrobial
diarrhea. Kuwait Medical Journal. 2005;3 7:91-3.
31. Hill PG. Gastric, pancreatic, and intestinal function. In:
Burtis CA, Ashwood ER, Bruns DE, editors. Tietz textbook
of clinical chemistry and molecular diagnostics. 4'h ed. St.
Louis: Elsevier Saunders, 1999; p. 1849-89.
32. Conway SP, Ireson A. Acute gastroenteritis in well nourished
infants : comparison of four feeding regiments. Arch Dish
Child. 1989;64:87-91.
Published
2009-12-31
How to Cite
1.
Aulia D, Timan IS, Firmansyah A. Fecal alpha-1 antitrypsin concentration in protein-losing enteropathies caused by Rotavirus and enteropathogenic bacteria infection. PI [Internet]. 31Dec.2009 [cited 22Dec.2024];49(6):315-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/590
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Received 2016-09-11
Accepted 2016-09-11
Published 2009-12-31
Accepted 2016-09-11
Published 2009-12-31
