Urinary trypsinogen-2 dipstick in acute pancreatitis.
OBJECTIVE
In acute pancreatitis (AP), rapid diagnosis and early treatment are of importance for clinical outcome. Urinary trypsinogen-2 has been suggested as a promising diagnostic marker; however, studies using the urinary trypsinogen-2 dipstick test (UTDT) have provided varying results.


METHODS
The study was set to evaluate the use of the UTDT (Actim Pancreatitis; Medix Biochemica, Kauniainen, Finland, Medinor, Roskilde, Denmark) in apparent first attack of AP in daily clinics. Acute pancreatitis was defined as more than a 3-fold increase in plasma amylase levels. We included 75 patients admitted with AP. Thirty-four patients with acute abdominal pain of causes other than AP served as a control group.


RESULTS
In 58 of 75 patients, the UTDT result was positive, giving a sensitivity of 77% (95% confidence interval [CI]: 66%-86%). In severe cases, the sensitivity improved to 87% (95% CI: 69%-96%). In 33 of 34 controls, the test result was negative, giving a specificity of 97% (95% CI: 84%-99.9%).


CONCLUSIONS
The UTDT had a low sensitivity but high specificity. These results do not support the UTDT to replace standard plasma amylase for the diagnosis of apparent first attack of AP. However, the test demonstrated an adequate sensitivity to be used for rapid early screening of AP in daily clinics.
Andersen
Anders Møller
AM
Department of Surgery K, Bispebjerg Hospital, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark. moeller.anders@gmail.com
Novovic
Srdan
S
Ersbøll
Annette Kjaer
AK
Jorgensen
Lars Nannestad
LN
Hansen
Mark Berner
MB
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis* / Q000652:urine*; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic / Q000592:standards; D011934:Reagent Strips; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014357:Trypsin / Q000652:urine*; D014362:Trypsinogen / Q000652:urine*; D055815:Young Adult
D011933:Reagent Kits, Diagnostic; D011934:Reagent Strips; C064831:PRSS2 protein, human; D014362:Trypsinogen; D000681:Amylases; D014357:Trypsin