The role of urine trypsinogen-2 test in the differential diagnosis of acute pancreatitis in the Emergency Department.
BACKGROUND
The aim of the study was to investigate the role and importance of the urine trypsinogen-2 dipstick test in the differential diagnosis of acute pancreatitis in the Emergency Department and to compare results with those of conventional tests.


METHODS
The study was performed prospectively in the patients admitting to the Emergency Department due to upper abdominal pain. Thirty-two of the 87 patients included in the study had acute pancreatitis diagnosis. Serum amylase, lipase, C-reactive protein (CRP) and urine trypsinogen-2 using Actim pancreatitis dipstick were studied in all patients. The statistical analysis was performed using SPSS 11.5 package program.


RESULTS
Urine trypsinogen-2 was found positive in 21 (65.6%) of 32 patients. The sensitivity of the test for pancreatitis was identified as 64%, specificity as 85%, positive predictive value as 72%, and negative predictive value as 81%. These values were statistically significant compared to the control group (p<0.01).


CONCLUSIONS
Although it has lower sensitivity and specificity compared to amylase and lipase, we suggest that urine trypsinogen-2 test may be an important diagnostic tool in excluding the diagnosis of acute pancreatitis, since it provides results within 5 minutes in the Emergency Department, is cheaper, has a higher negative predictive value, and is easy to use.
Cevik
Yunsur
Y
Department of Emergency Medicine, Atatürk Training and Research Hospital, Ankara, Turkey. yunsurcevik@yahoo.com
Kavalci
Cemil
C
Ozer
Mehmet
M
Daş
Murat
M
Kiyak
Gülten
G
Ozdoğan
Mehmet
M
D000208:Acute Disease; D000681:Amylases / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D006801:Humans; D008049:Lipase / Q000097:blood; D010146:Pain; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000652:urine; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014357:Trypsin / Q000652:urine*; D014362:Trypsinogen / Q000652:urine*
C064831:PRSS2 protein, human; D014362:Trypsinogen; D002097:C-Reactive Protein; D008049:Lipase; D000681:Amylases; D014357:Trypsin