We occasionally get requests to send distal duodenal biopsies off for determination of mucosal content of the disaccharidases, lactase, maltase, sucrase, palatinase, and for glucoamylase.

1. Biopsy to be received without fixative

2. Biopsy to snap-freeze and ship on dry ice

3. ship to: U. of Maryland, Division of Pediatric Gastroenterology & Nutrition, UMAB, 655 W. Baltimore St. Room 10-047, Baltimore, Maryland  21201, 410-706-1997 or 1998; fax 410-706-0020; contact person is Ms. Athba Hammed...see item #9, below

4. in Oct. 2001, test cost is about $150.00

5. case examples: LMC-01-6412; LMC-01-8142

6. these are usually on patients having EGDs (@ LMC, ext. 2343)  by Dr. Rathna Amarnath (who also does procedures at P-RMH [434-4090; 434-4080]& P-BMC [771-5144; 771-5612]). His fax is 803-254-2090; clinical info can be obtained from his nurse, Karen 803-254-1006.

7. Biopsy 90% of the time: Surgical Pathology will ship the biopsies. If reasonable, pathologist should get a little piece for local morphology. Deficiencies of the disaccharidases as the cause of diarrhea and malabsorption are correlated with morphological loss of brush border zone or decrease of total brush border surface area by way of villous atrophy (brush border excellently decorated by the IHC marker for CD10). Lactase is the most common deficiency, followed by sucrase.

8. Liquid specimens 10% of the time: in instances of possible pancreatic insufficiency, he may  forward timed duodenal juice aspirates for analysis of pancreatic enzymes as a pancreatic function test battery (amylase, lipase, trypsin, chymotrypsin, carboxypeptidase A&B, protein, and pH)...shipped frozen on dry ice; charge of about $125 per specimen. Chemistry send-out will ship these.

9. As of 3/10/03 Dr. Armanath wants to use Joli Diagnostic, Inc., 1348 North Forest Road, Williamsville, New York; 716-639-0443, fax 716-639-0471