title: Utility of Direct Pancreatic Function Testing in Children.
abstract: Exocrine pancreatic insufficiency (EPI) can have a significant impact on a child's growth and nutrition. Our aim was to evaluate the utility of direct endoscopic pancreatic function testing (ePFT) in pediatrics.
  
  
  
  A single-center retrospective chart review was performed of children who underwent ePFT from December 2007 through February 2015. Endoscopic pancreatic function testings were performed by 1 of 2 methods: (1) intravenous cholecystokinin, followed by the collection of a single duodenal aspirate at 10 minutes, or (2) intravenous cholecystokinin or secretin, followed by the collection of 3 duodenal aspirates at a 5, 10, and 15 minutes. Samples were tested for pH and enzyme activities.
  
  
  
  A total of 508 ePFTs were performed (481 single-sample tests, 27 multiple-sample tests). Based on the multiple-sample group, enzyme levels for chymotrypsin, amylase, and lipase peaked at 5 minutes, followed by a decrease in activity over time. Exocrine pancreatic sufficiency was identified in 373 (73.4%) and EPI in 93 (18.3%). Exocrine pancreatic sufficiency analysis found all pancreatic enzyme activities significantly increase with age: trypsin, chymotrypsin, amylase, and lipase, (P < 0.05).
  
  
  
  Endoscopic pancreatic function testing can be used in the evaluation of EPI in children. Normative data suggest that pancreatic enzyme activities mature with age.
authors.affiliation: From the *Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; †Heim Pál Children's Hospital, Budapest; ‡1st Department of Medicine, University of Szeged, MTA-SZTE Momentum Translational Gastroenterology Research Group Institute for Translational Medicine, University of Pécs, Pécs, Hungary; §University of Cincinnati College of Medicine; and ∥Division of Biostatistics and Epidemiology, ¶Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Ligia
authors.initials: L
authors.lastname: Alfaro Cruz
authors.forename: Andrea
authors.initials: A
authors.lastname: Parniczky
authors.forename: Allison
authors.initials: A
authors.lastname: Mayhew
authors.forename: Lindsey N
authors.initials: LN
authors.lastname: Hornung
authors.forename: Tom K
authors.initials: TK
authors.lastname: Lin
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Palermo
authors.forename: Kimberly
authors.initials: K
authors.lastname: Jackson
authors.forename: Maisam
authors.initials: M
authors.lastname: Abu-El-Haija
mesh_terms: D000681:Amylases / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D002918:Chymotrypsin / Q000378:metabolism; D056947:Enzyme Replacement Therapy; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis* / Q000201:enzymology* / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008049:Lipase / Q000378:metabolism; D008297:Male; D010186:Pancreatic Function Tests / Q000379:methods* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014357:Trypsin / Q000378:metabolism
chemical_list: D008049:Lipase; D000681:Amylases; D002918:Chymotrypsin; D014357:Trypsin