Fecal pancreatic elastase: A reproducible marker for severe exocrine pancreatic insufficiency

Satoru Naruse, Hiroshi Ishiguro, Shigeru B.H. Ko, Toshiyuki Yoshikawa, Takeshi Yamamoto, Akiko Yamamoto, Sachiko Futakuchi, Hidemi Goto, Yukio Saito, Susumu Takahashi

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52 Citations (Scopus)

Abstract

Background: In order to apply fecal pancreatic elastase for follow-up of exocrine pancreatic function in chronic pancreatitis and cystic fibrosis, we examined the sensitivity, specificity, and long-term variability of a new polyclonal antibody-based enzyme-linked immunosorbent assay (ELISA). Methods: Patients with definite chronic pancreatitis (n = 23), probable or possible chronic pancreatitis (n = 14), autoimmune pancreatitis (n = 7), or acute pancreatitis (n = 11), and 51 healthy subjects and 11 healthy infants participated in this study. Pancreatic function was graded as normal (n = 3), mild (n = 18), moderate (n = 9), or severe (n = 18) exocrine insufficiency on the basis of secretin tests. Fecal pancreatic elastase was measured by a new ELISA. Results: Fecal pancreatic elastase concentration in control subjects varied widely, with a median of 478 μg/g. The specificity of this test was 90.2% with a cutoff value of >200 μg/g. The sensitivities were 60.9% for detecting definite chronic pancreatitis, 76.5% for calcifying pancreatitis, 71.4% for autoimmune pancreatitis, and 7.1% for probable or possible chronic pancreatitis. The sensitivities were 16.7% for mild, 12.5% for moderate, and 72.2% for severe exocrine pancreatic insufficiency. Forty patients were reexamined after a median interval of 347 days. The fecal pancreatic elastase levels between the first and second tests were not significantly different. Two infants, 4.5 and 5 months old, had abnormally low values, but after a median of 304 days all infants showed normal levels (median, 444 μg/g). Conclusions: Fecal pancreatic elastase is a reproducible marker for severe exocrine pancreatic insufficiency. This test is valuable for longitudinal follow-up of exocrine pancreatic function.

Original languageEnglish
Pages (from-to)901-908
Number of pages8
JournalJournal of gastroenterology
Volume41
Issue number9
DOIs
Publication statusPublished - 2006 Sep 1

Keywords

  • Chronic pancreatitis
  • Fecal pancreatic elastase
  • Infant
  • Pancreatic insufficiency
  • Secretin test

ASJC Scopus subject areas

  • Gastroenterology

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    Naruse, S., Ishiguro, H., Ko, S. B. H., Yoshikawa, T., Yamamoto, T., Yamamoto, A., Futakuchi, S., Goto, H., Saito, Y., & Takahashi, S. (2006). Fecal pancreatic elastase: A reproducible marker for severe exocrine pancreatic insufficiency. Journal of gastroenterology, 41(9), 901-908. https://doi.org/10.1007/s00535-006-1884-0