Journal of Gastroenterology

, Volume 41, Issue 9, pp 901–908

Fecal pancreatic elastase: a reproducible marker for severe exocrine pancreatic insufficiency

  • Satoru Naruse
  • Hiroshi Ishiguro
  • Shigeru B.H. Ko
  • Toshiyuki Yoshikawa
  • Takeshi Yamamoto
  • Akiko Yamamoto
  • Sachiko Futakuchi
  • Hidemi Goto
  • Yukio Saito
  • Susumu Takahashi
Article

DOI: 10.1007/s00535-006-1884-0

Cite this article as:
Naruse, S., Ishiguro, H., Ko, S. et al. J Gastroenterol (2006) 41: 901. doi:10.1007/s00535-006-1884-0

Abstract

Background

In order to apply fecal pancreatic elastase for follow-up of exocrine pancreatic function in chronic pancreatitis and cystic fibrosis, we examined the sensitivity, specificity, and long-term variability of a new polyclonal antibody-based enzyme-linked immunosorbent assay (ELISA).

Methods

Patients with definite chronic pancreatitis (n = 23), probable or possible chronic pancreatitis (n = 14), autoimmune pancreatitis (n = 7), or acute pancreatitis (n = 11), and 51 healthy subjects and 11 healthy infants participated in this study. Pancreatic function was graded as normal (n = 3), mild (n = 18), moderate (n = 9), or severe (n = 18) exocrine insufficiency on the basis of secretin tests. Fecal pancreatic elastase was measured by a new ELISA.

Results

Fecal pancreatic elastase concentration in control subjects varied widely, with a median of 478 µg/g. The specificity of this test was 90.2% with a cutoff value of >200 µg/g. The sensitivities were 60.9% for detecting definite chronic pancreatitis, 76.5% for calcifying pancreatitis, 71.4% for autoimmune pancreatitis, and 7.1% for probable or possible chronic pancreatitis. The sensitivities were 16.7% for mild, 12.5% for moderate, and 72.2% for severe exocrine pancreatic insufficiency. Forty patients were reexamined after a median interval of 347 days. The fecal pancreatic elastase levels between the first and second tests were not significantly different. Two infants, 4.5 and 5 months old, had abnormally low values, but after a median of 304 days all infants showed normal levels (median, 444 µg/g).

Conclusions

Fecal pancreatic elastase is a reproducible marker for severe exocrine pancreatic insufficiency. This test is valuable for longitudinal follow-up of exocrine pancreatic function.

Key words

fecal pancreatic elastasesecretin testpancreatic insufficiencychronic pancreatitisinfant

Copyright information

© Springer-Verlag Tokyo 2006

Authors and Affiliations

  • Satoru Naruse
    • 1
  • Hiroshi Ishiguro
    • 1
    • 2
  • Shigeru B.H. Ko
    • 1
  • Toshiyuki Yoshikawa
    • 1
  • Takeshi Yamamoto
    • 1
  • Akiko Yamamoto
    • 2
  • Sachiko Futakuchi
    • 1
  • Hidemi Goto
    • 1
  • Yukio Saito
    • 3
  • Susumu Takahashi
    • 4
  1. 1.Department of GastroenterologyNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of Human NutritionNagoya University Graduate School of MedicineNagoyaJapan
  3. 3.Chubu Health Care CenterNagoyaJapan
  4. 4.Nihon Schering K.K.SakuraJapan