Article1 June 1960UROPEPSIN EXCRETION IN THE DIFFERENTIAL DIAGNOSIS OF GASTROINTESTINAL BLEEDINGALVIN J. CUMMINS, M.D., F.A.C.P.ALVIN J. CUMMINS, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-52-6-1213 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptINTRODUCTIONSeveral proteolytic enzymes are known to exist in the blood and urine, and one of the urinary enzymes—uropepsin—has received much attention and study since Bucher's review of the subject in 1947.1Available evidence indicates that the chief cells of the gastric glands secrete pepsinogen both into the gastric lumen and into the blood in a ratio of about 99:1.2In the stomach the enzyme precursor is activated to pepsin by hydrochloric acid, while from the blood stream it is excreted in the urine, where it can be assayed at an acid pH as uropepsin. Urinary excretion of uropepsin has...Bibliography1. Bucher GR: Uropepsin: review of literature and report of some experimental findings, Gastroenterology 8: 627, 1947. MedlineGoogle Scholar2. JanowitzHollander HDF: Relation of uropepsinogen excretion to gastric pepsin secretion in man, J. Appl. Physiol. 4: 53, 1951. CrossrefMedlineGoogle Scholar3. HoarBrowning CSJR: Plasma pepsinogen in peptic-ulcer disease and other gastric disorders, New England J. Med. 255: 153, 1956. CrossrefMedlineGoogle Scholar4. JanowitzLevyHollander HDMHF: The diagnostic significance of urinary pepsinogen excretion in diseases of the upper gastrointestinal tract, Am. J. M. Sc. 220: 679, 1950. CrossrefMedlineGoogle Scholar5. GrayRamseyReifenstein SJCGRW: Clinical use of the urinary uropepsin determination in medicine and surgery, New England J. Med. 251: 835, 1954. CrossrefMedlineGoogle Scholar6. CorazzaMyerson LJRM: The influence of various clinical disorders and drugs on excretion of uropepsin, J. A. M. A. 165: 146, 1957. CrossrefMedlineGoogle Scholar7. Sircus W: Studies of uropepsinogen excretion in gastrointestinal disorders, Quart. J. Med. 23: 291, 1954. MedlineGoogle Scholar8. EastcottFawcettRob HHJKCG: Some factors affecting uropepsinogen excretion in man, Lancet 1: 1068, 1953. CrossrefMedlineGoogle Scholar9. LevyLevine AHS: Uropepsin excretion studies in clinical surgery, Gastroenterology 30: 270, 1956. CrossrefMedlineGoogle Scholar10. CubberleyDagradiCarneStempien DAAEHOSJ: Uropepsin excretion in gastroduodenal disease—a correlative clinical study, Gastroenterology 28: 80, 1955. CrossrefMedlineGoogle Scholar11. Broh-KahnPodoreMirsky RHCJIA: Uropepsin excretion by man. II. Uropepsin excretion by healthy men, J. Clin. Investigation 27: 825, 1948. CrossrefGoogle Scholar12. AnsonMirsky MLAE: The estimation of pepsin with hemoglobin, J. Gen. Physiol. 16: 59, 1943. CrossrefGoogle Scholar13. BonsnesTaussky RWHH: On the colorimetric determination of creatinine by the Jaffe reaction, J. Biol. Chem. 158: 581, 1945. CrossrefGoogle Scholar14. SchiffMacBryde LCM: Signs and symptoms—their clinical interpretation, 1947, J. B. Lippincott Co., Philadelphia. Google Scholar15. Hirschowitz BI: Pepsinogen: its origins, secretion and excretion, Physiol. Rev. 37: 475, 1957. CrossrefMedlineGoogle Scholar16. SpiroRyanJones HMAECM: The relation of blood pepsin to gastric secretion, with particular reference to anacidity and achylia, Gastroenterology 30: 563, 1956. CrossrefMedlineGoogle Scholar17. Cummins AJ: Unpublished observations. Google Scholar18. SilverPucciAlmy HMHTP: Effects of anticholinergic drugs on pepsin production and uropepsinogen excretion, New England J. Med. 252: 520, 1955. CrossrefMedlineGoogle Scholar19. ZamcheckChalmersWhiteDavidson NTCFWCS: The bromsulphalein test in early diagnosis of liver disease in gross upper gastrointestinal hemorrhage, Gastroenterology 14: 343, 1950. CrossrefGoogle Scholar20. McDermott WV: A simple discriminatory test for upper gastrointestinal hemorrhage, New England J. Med. 257: 1161, 1957. CrossrefMedlineGoogle Scholar21. BelkinConn GAHO: Blood ammonia concentration and bromsulfalein retention in upper gastrointestinal hemorrhage, New England J. Med. 260: 530, 1959. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication November 16, 1959.Presented at the Tennessee-Kentucky Regional Meeting of The American College of Physicians, Nashville, Tennessee, October 31, 1959.From the Gastrointestinal Laboratory, Department of Medicine, University of Tennessee College of Medicine, and the John Gaston Hospital, Memphis.†This work was supported by a grant from the U. S. Public Health Service (N.I.H. RG-4829).Requests for reprints should be addressed to Alvin J. Cummins, M.D., Associate Professor of Medicine, The University of Tennessee, 858 Madison Avenue, Memphis 3, Tennessee. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byConstitution, genetics, and body form in peptic ulcer: A review 1 June 1960Volume 52, Issue 6Page: 1213-1220KeywordsBlood cellsDuodenal ulcersEnzymesExcretionHemorrhageHospital medicineRiversStomachUlcersUrine ePublished: 1 December 2008 Issue Published: 1 June 1960 PDF downloadLoading ...