Diagnostic Accuracy of a Short Endoscopic Secretin Test in Patients With Cystic Fibrosis.
OBJECTIVE
Short endoscopic secretin tests for exocrine pancreatic function are not properly evaluated in cystic fibrosis (CF).


METHODS
Patients with CF and healthy controls (HCs) underwent endoscopic collection of duodenal juice between 30 and 45 minutes after secretin stimulation. Duodenal juice was analyzed for HCO3 concentration and pancreatic enzyme activities. Stool was analyzed for fecal elastase.


RESULTS
Thirty-one patients with CF and 25 HCs were tested. Patients were classified as exocrine pancreatic sufficient (n = 13) or insufficient (n = 18). Both bicarbonate concentrations and enzyme activities in duodenal juice differentiated patients with CFI from patients with CFS and HC (P < 0.001). The population displays strong correlation between severe CF genotype in both alleles and pancreatic insufficient phenotype (P < 0.001).


CONCLUSIONS
Pancreatic exocrine insufficient CF patients could be differentiated from exocrine sufficient patients and HCs using short endoscopic secretin test.
From the *Department of Clinical Medicine, University of Bergen; †Department of Medicine, Haukeland University Hospital; ‡Department of Medicine, Voss Hospital, Voss; §Department of Thoracic Medicine, Haukeland UniversityHospital; ∥Department of Clinical Science, University of Bergen, Bergen; ¶Pediatric Department, Haukeland University Hospital; and #National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway.
Trond
T
Engjom
Friedemann
F
Erchinger
Birger Norderud
BN
Lærum
Erling
E
Tjora
Lage
L
Aksnes
Odd Helge
OH
Gilja
Georg
G
Dimcevski
D000293:Adolescent; D000328:Adult; D000368:Aged; D001639:Bicarbonates / Q000378:metabolism; D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000378:metabolism; D004386:Duodenum / Q000378:metabolism; D004724:Endoscopy / Q000379:methods*; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis* / Q000378:metabolism; D005243:Feces / Q000201:enzymology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000378:metabolism; D010186:Pancreatic Function Tests / Q000379:methods*; D015203:Reproducibility of Results; D012633:Secretin / Q000008:administration & dosage; D012680:Sensitivity and Specificity; D055815:Young Adult
D001639:Bicarbonates; D012633:Secretin; D010196:Pancreatic Elastase