title: Urinary trypsinogen-2 dipstick in acute pancreatitis.
abstract: 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.
authors.affiliation: Department of Surgery K, Bispebjerg Hospital, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark. moeller.anders@gmail.com
authors.forename: Anders Møller
authors.initials: AM
authors.lastname: Andersen
authors.forename: Srdan
authors.initials: S
authors.lastname: Novovic
authors.forename: Annette Kjaer
authors.initials: AK
authors.lastname: Ersbøll
authors.forename: Lars Nannestad
authors.initials: LN
authors.lastname: Jorgensen
authors.forename: Mark Berner
authors.initials: MB
authors.lastname: Hansen
mesh_terms: 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
chemical_list: D011933:Reagent Kits, Diagnostic; D011934:Reagent Strips; C064831:PRSS2 protein, human; D014362:Trypsinogen; D000681:Amylases; D014357:Trypsin