title: Comparison of diagnostic methods for pancreatic insufficiency in infants with cystic fibrosis.
abstract: OBJECTIVE
  The objective of the present study is to compare daily weight gain and laboratory analysis (72-hour fecal fat and steatocrit) with fecal elastase-1 (EL-1) when diagnosing pancreatic insufficiency (PI) in infants with cystic fibrosis (CF).
  
  
  METHODS
  A total of 39 infants with CF, diagnosed consecutively by newborn screening at 2 referral centers, were included in the study. Daily weight gain and results of laboratory analysis of stool samples were compared using the κ coefficient and the receiver operator characteristic (ROC) curve.
  
  
  RESULTS
  Using the criterion of low daily weight gain, the frequency of PI was 92.3%; using the 72-hour fecal fat, steatocrit, and fecal EL-1 tests, the frequency was 42.3%, 86.2%, and 84.6%, respectively. EL-1 was used as the reference test. It was observed that the criteria of low daily weight gain (<50th percentile) and abnormal steatocrit, used together, showed the highest sensitivity (91.3%) and specificity (83.3%) for the diagnosis of PI.
  
  
  CONCLUSIONS
  When fecal EL-1 analysis is not immediately available, low daily weight gain associated with abnormal steatocrit can be adopted as a criterion for initiating pancreatic enzyme replacement therapy in infants with CF; however, EL-1 testing should be performed later for confirmation of PI.
authors.affiliation: University Hospital/Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Amanda C S
authors.initials: AC
authors.lastname: Tardelli
authors.forename: Paulo A M
authors.initials: PA
authors.lastname: Camargos
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Penna
authors.forename: Pauliane F B
authors.initials: PF
authors.lastname: Sarkis
authors.forename: Elizabet V
authors.initials: EV
authors.lastname: Guimarães
mesh_terms: D003550:Cystic Fibrosis / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D005223:Fats / Q000378:metabolism*; D005243:Feces / Q000737:chemistry*; D005260:Female; D006128:Growth; D006130:Growth Disorders / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D010196:Pancreatic Elastase / Q000378:metabolism*; D012372:ROC Curve; D012016:Reference Values; D012680:Sensitivity and Specificity; D015430:Weight Gain
chemical_list: D005223:Fats; D010196:Pancreatic Elastase