OBJECTIVES: To evaluate the role of fecal elastase 1 (E1) as a marker of exocrine pancreatic insufficiency (PI). STUDY DESIGN: Fecal E1 was measured in patient groups with (1) failure to thrive but no pancreatic or intestinal disease (disease control patients); (2) PI; (3) pancreatic sufficiency; and (4) steatorrhea caused by a variety of intestinal diseases. RESULTS: Fecal E1 in all disease control patients exceeded 200 microg/g stool. Only 1 (2%) of 50 patients with PI exceeded the minimum reference value of 100 microg/g stool. In contrast, 3 (11%) of 28 patients with pancreatic sufficiency (with Shwachman-Diamond syndrome) had fecal E1 concentrations <100 microg/g stool, as did 5 (20%) of 25 patients with steatorrhea from intestinal causes, all of whom had diluted feces caused by short gut. CONCLUSIONS: Fecal E1 is a useful noninvasive screening test of PI in childhood. A negative test (>100 microg/g stool) had 99% predictive value for ruling out PI. However, a positive test in those with short gut or Shwachman-Diamond syndrome must be interpreted with caution.
OBJECTIVES: To evaluate the role of fecal elastase 1 (E1) as a marker of exocrine pancreatic insufficiency (PI). STUDY DESIGN: Fecal E1 was measured in patient groups with (1) failure to thrive but no pancreatic or intestinal disease (disease control patients); (2) PI; (3) pancreatic sufficiency; and (4) steatorrhea caused by a variety of intestinal diseases. RESULTS: Fecal E1 in all disease control patients exceeded 200 microg/g stool. Only 1 (2%) of 50 patients with PI exceeded the minimum reference value of 100 microg/g stool. In contrast, 3 (11%) of 28 patients with pancreatic sufficiency (with Shwachman-Diamond syndrome) had fecal E1 concentrations <100 microg/g stool, as did 5 (20%) of 25 patients with steatorrhea from intestinal causes, all of whom had diluted feces caused by short gut. CONCLUSIONS: Fecal E1 is a useful noninvasive screening test of PI in childhood. A negative test (>100 microg/g stool) had 99% predictive value for ruling out PI. However, a positive test in those with short gut or Shwachman-Diamond syndrome must be interpreted with caution.
Authors: Miroslav Vujasinovic; Bojan Tepes; Bojan Vujkovac; Andreja Cokan Vujkovac; Martin Tretjak; Vesna Korat Journal: Wien Klin Wochenschr Date: 2015-04-03 Impact factor: 1.704
Authors: Drucy Borowitz; Richard B Parad; Jack K Sharp; Kathryn A Sabadosa; Karen A Robinson; Michael J Rock; Philip M Farrell; Marci K Sontag; Margaret Rosenfeld; Stephanie D Davis; Bruce C Marshall; Frank J Accurso Journal: J Pediatr Date: 2009-12 Impact factor: 4.406
Authors: Miroslav Vujasinovic; Bojan Tepes; Jana Makuc; Sasa Rudolf; Jelka Zaletel; Tjasa Vidmar; Maja Seruga; Bostjan Birsa Journal: World J Gastroenterol Date: 2014-12-28 Impact factor: 5.742