RESUMO
OBJECTIVE: To determine the effect of anemia and iron status on intestinal permeability in children. DESIGN: A routine prospective study was performed in 64 children with symptoms suggesting cow's milk allergy (CMA) (11.8 +/- 16 mo, 2-94 mo). They exhibited a negative cow's milk challenge upon the ESPGHAN criteria. Hemoglobin (Hb), mean corpuscular volume (MCV), blood iron (Fe) and ferritin (Fer) concentrations were studied in all. Permeability was measured as percent of urinary excretion of lactitol (L,%) and mannitol (M,%) (oral absorption, 0.1 g/Kg for each sugar) and determination of the L/M ratio (L/M,%). RESULTS: L/M was significantly higher in anemic children than in non-anemic ones, 2.45, (median), 1.92-3.43 (extremes), n = 29, vs. 1.72, 1.56-2.18, n = 35, p = 0.03. Hb correlated negatively with L/M (p = 0.0001) and L (p = 0.05) and positively with M (p = 0.03). Also, L/M correlated negatively with MCV (p = 0.001) and Fe (p = 0.04). CONCLUSION: IP depends on anemia and iron status. The interpretation of IP should be taken cautiously into account in the diagnosis of CMA in case of anemia or iron deficiency.
