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Fecal pancreatic elastase 1 in the work Up of patients with chronic diarrhea

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Summary

Background. Quantitative determination of pancreatic elastase-1 (E1) in stools has been proposed as a novel, noninvasive test of pancreatic function. The aim of the study was to verify its role in the differential diagnosis of chronic diarrhea.

Methods. E1 was measured in spot stool samples of 50 patients with pancreatic disease (PD), 62 with inflammatory bowel disease (IBD), 45 with chronic diarrhea (CD), 34 with other gastroduodenal and liver disease (gastrointestinal; GI), and in 18 normal controls, by a commercial kit (Schebo-Tech., Wettemburg, Germany).

Results. In PD, patients with severe damage and diarrhea displayed E1 levels below 100 µg/g; normal values were found in mild-moderate disease. Abnormal values were detected in 4 CD and in 14 IBD patients, either in the presence of severe protein malnutrition or in patients with previous ileo-anal pouch anastomosis and pouchitis. In nine cases, values reverted to normal after adequate treatment. Diagnostic accuracy of E1 in discriminating diarrhea of pancreatic and nonpancreatic origin was: SS, 97%; SP, 84%; VP+, 66%; VP−, 100%.

Conclusion. 1 The finding of a normal E1 value rules out a malabsorption of pancreatic origin. 2) in CD and IBD, decreased E1 might be owing to bacterial elastase degradation (pouchitis) or transient defective pancreatic enzyme secretion.

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Authors and Affiliations

  1. Central Laboratory, Mauriziano Hospital, Torino, Italy

    Caterina Zaffino & Lucrezia Gallo

  2. Department of Gastroenterology, Mauriziano Hospital, L.go Turati 62, 10128, Torino, Italy

    Guya Masoero, Cristiana Laudi, Lucio Lombardo, Rodolfo Rocca, Patrizia Della Monica & Angelo Pera

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  1. Guya Masoero
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  2. Caterina Zaffino
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  3. Cristiana Laudi
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  4. Lucio Lombardo
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  7. Patrizia Della Monica
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  8. Angelo Pera
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Correspondence to Guya Masoero.

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Masoero, G., Zaffino, C., Laudi, C. et al. Fecal pancreatic elastase 1 in the work Up of patients with chronic diarrhea. International Journal of Pancreatology 28, 175–179 (2000). https://doi.org/10.1385/IJGC:28:3:175

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  • DOI: https://doi.org/10.1385/IJGC:28:3:175

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