Detection and follow up of exocrine pancreatic insufficiency in cystic fibrosis: a review.
Pancreatic function testing is particularly difficult when the degree of remaining function has to be quantified. Detection of pancreatic insufficiency can suggest the diagnosis of cystic fibrosis (CF). It is, however, also important to follow the degree of pancreatic insufficiency in CF since its function can decline with age. Adaptation of pancreatic enzyme replacement therapy on residual function is necessary. Different tests with their advantages and disadvantages are critically reviewed in this article with respect to specificity, sensitivity, performance and cost-effectiveness.


CONCLUSIONS
Elastase-1 detection in faeces is probably the easiest test for the detection of pancreatic insufficiency in cystic fibrosis. For clinical follow-up tests, measuring the fat assimilation such as steatocrit and breath tests are more suited.
Leus
J
J
Ghent University Hospital, Belgium. Jasmineleus@hotmail.com
Van Biervliet
S
S
Robberecht
E
E
D000359:Aftercare / Q000379:methods; D001944:Breath Tests / Q000379:methods; D003362:Cost-Benefit Analysis; D003550:Cystic Fibrosis / Q000150:complications*; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D005243:Feces / Q000737:chemistry / Q000201:enzymology; D006801:Humans; D010196:Pancreatic Elastase / Q000032:analysis; D010186:Pancreatic Function Tests / Q000191:economics / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D010196:Pancreatic Elastase