Faecal elastase 1 in children with cystic fibrosis.
Recently, a new ELISA kit for determination of elastase 1 in faeces has become commercially available. Studies in patients with chronic pancreatitis have indicated that it is a simple and sensitive test of exocrine pancreatic function. The aim of this study was to assess the clinical value of this new test in cystic fibrosis. A total of 72 children were studied: 27 who were healthy, 22 with cystic fibrosis and 23 with non-pancreatic disorders. Oral pancreatic extracts were not discontinued in the children with cystic fibrosis. A small sample of faeces was collected from each subject for elastase 1 concentration and chymotrypsin activity determination. In all of the healthy children and most of those with non-pancreatic disorders (20/23), elastase 1 concentrations were greater than 500 microg/g; in contrast, the vast majority (20/22) of children with cystic fibrosis had very low values (less than 20 microg/g). The differences between children with cystic fibrosis and the other two groups were highly significant (P < 0.001). With a cut-off level of 132 microg/g, the sensitivity and specificity of faecal elastase 1 for the determination of exocrine pancreatic insufficiency were 96% and 100%, respectively. The specificity of faecal chymotrypsin was 96%, but its sensitivity was not calculated since the children with cystic fibrosis continued to take pancreatic extracts during the study.


CONCLUSIONS
The determination of faecal elastase 1 concentration is a simple and reliable means of assessing exocrine pancreatic function in children with cystic fibrosis. Results are not influenced by non-pancreatic disorders or by enzyme supplementation.
Gullo
L
L
Department of Internal Medicine and Gastroenterology, St. Orsola Hospital, Bologna, Italy.
Graziano
L
L
Babbini
S
S
Battistini
A
A
Lazzari
R
R
Pezzilli
R
R
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002918:Chymotrypsin / Q000032:analysis; D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000201:enzymology; D004797:Enzyme-Linked Immunosorbent Assay; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis / Q000201:enzymology; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010196:Pancreatic Elastase / Q000032:analysis*; D010186:Pancreatic Function Tests; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity
D011933:Reagent Kits, Diagnostic; D002918:Chymotrypsin; D010196:Pancreatic Elastase