Abstract
The determination of fecal concentration of pancreatic elastase 1 (E1) has recently been described as a valuable parameter for estimation of exocrine pancreatic function (Scheefers-Borchel U et al. Lab med 1992;16:427). The aim of our study was the comparison of the E1 concentration in feces with the results of sekretin-pancreozymin-test in CF-patients. Material and Methods: Sensitivity of fecal E1 concentration was determined in 16 CF-patients (median of age 17.3 yr) on pancreatic enzyme replacement therapy. Specificity was assessed in 23 healthy children (median of age 5.7 yr). Fecal E1 was determined with an ELISA based on two monoclonal antibodies against human Elastase 1 (Schebo•Tech GmbH, Wettenberg, Germany). Aliquots of a homogenized 24h-stool-collection were tested. Pancreatic function was classified according to fecal E1 concentration as follows: Table Results and conclusion: According to secretin-pancreozymin-test 15 of the 16 investigated CF-patients had a severe pancreatic insufficiency and only 1 patient was moderately insufficient. The determination of fecal E1 concentration had a sensitivity to (severe) pancreatic insufficiency of 100% and a specificity of 96%. E1 determination in stool seems to be a more sensitive and specific test for pancreatic insufficiency than other indirect tube-less tests. Moreover, pancreatic function can be assessed without interruption of pancreatic enzyme therapy.
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