Point-of-care urine trypsinogen testing for the diagnosis of pancreatitis.
OBJECTIVE
To assess a point-of-care (POC) urine trypsinogen (UT) test for the diagnosis of pancreatitis in the emergency department (ED).


METHODS
This was a prospective cohort study of a convenience sample of patients presenting to the ED with abdominal pain or symptoms suggestive of pancreatitis. A 3-minute POC UT test (Actim Pancreatitis; Medix Biochemica, Kauniainen, Finland) was compared with plasma lipase and amylase measurements, imaging results when performed, and final discharge diagnoses. The criterion standard was a final discharge diagnosis of acute pancreatitis.


RESULTS
Of 191 patients included in this study, 17 patients were diagnosed with either acute or acute-on-chronic pancreatitis. The sensitivity and specificity of UT for acute pancreatitis were, respectively, 100% (95% confidence interval [CI] = 77% to 100%) and 96% (95% CI = 92% to 98%). Seven of the 17 patients with pancreatitis (41%) had diagnostic findings on CT and positive UT tests but had nondiagnostic plasma lipase and amylase levels.


CONCLUSIONS
A POC UT screening test for pancreatitis in the ED compared favorably with plasma lipase and amylase levels. Future studies should be performed to explore whether this test in the ED setting has better clinical utility than plasma lipase or amylase.
Jang
Timothy
T
Department of Emergency Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA. jangt@msnotes.wustl.edu
Uzbielo
Alison
A
Sineff
Sanford
S
Naunheim
Rosanne
R
Scott
Mitchell G
MG
Lewis
Lawrence M
LM
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000681:Amylases / Q000097:blood; D006801:Humans; D008049:Lipase / Q000097:blood; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis*; D050500:Pancreatitis, Chronic / Q000175:diagnosis; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014362:Trypsinogen / Q000652:urine*
D014362:Trypsinogen; D008049:Lipase; D000681:Amylases