Reliable screening for acute pancreatitis with rapid urine trypsinogen-2 test strip.
BACKGROUND
This study was designed to evaluate the validity of a new rapid urinary trypsinogen-2 test strip (Actim Pancreatitis) for detection of acute pancreatitis in patients with acute abdominal pain.


METHODS
A total of 525 consecutive patients presenting with abdominal pain at two emergency units was included prospectively and tested with the Actim Pancreatitis test strip. Urine trypsinogen-2 concentrations were also determined by a quantitative method. The diagnosis and assessment of severity of acute pancreatitis was based on raised serum and urinary amylase levels, clinical features and findings on dynamic contrast-enhanced computed tomography.


RESULTS
In 45 patients the diagnosis of acute pancreatitis could be established. The Actim Pancreatitis test strip result was positive in 43 of them resulting in a sensitivity of 96 per cent. Thirty-seven false-positive Actim Pancreatitis test strips were obtained in patients with non-pancreatic abdominal pain resulting in a specificity of 92 per cent. Nine patients with severe acute pancreatitis were all detected by the dipstick.


CONCLUSIONS
A negative Actim Pancreatitis strip result excludes acute pancreatitis with high probability. Positive results indicate the need for further evaluation, i.e. other enzyme measurements and/or radiological examinations. The test is easy and rapid to perform, unequivocal in its interpretation and can be used in healthcare units lacking laboratory facilities.
Kylänpää-Bäck
M
M
Second Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Kemppainen
E
E
Puolakkainen
P
P
Hedström
J
J
Haapiainen
R
R
Perhoniemi
V
V
Kivilaakso
E
E
Korvuo
A
A
Stenman
U
U
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D004796:Clinical Enzyme Tests; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014357:Trypsin; D014362:Trypsinogen / Q000652:urine*
D015415:Biomarkers; C064831:PRSS2 protein, human; D014362:Trypsinogen; D014357:Trypsin