How useful is fecal pancreatic elastase 1 as a marker of exocrine pancreatic disease?

Abstract

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: Satti Beharry, Lynda Ellis, Mary Corey, Margaret Marcon, Peter Durie
• Journal: The Journal of pediatrics (J Pediatr) Vol. 141 Issue 1 Pg. 84-90 (Jul 2002) ISSN: 0022-3476 [Print] United States
• PMID: 12091856 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Pancreatic Elastase

Topics

• Adolescent
• Biomarkers
• Case-Control Studies
• Child
• Child, Preschool
• Cystic Fibrosis (complications)
• Exocrine Pancreatic Insufficiency (diagnosis, etiology)
• Feces (chemistry)
• Humans
• Infant
• Malabsorption Syndromes (complications)
• Pancreatic Elastase (metabolism)
• Pancreatic Function Tests (methods)
• Sensitivity and Specificity