Stool elastase as a diagnostic test for pancreatic function in children with cystic fibrosis
| Autor: | Theresa Leung, Colin Wallis, Anthony Reynolds, David Cubitt |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
Pancreatic disease Adolescent Cystic Fibrosis Meconium Ileus Pilot Projects Screen test Gastroenterology Cystic fibrosis Feces Meconium Internal medicine medicine Humans Child Pancreatic elastase Pancreatic Elastase biology business.industry Elastase Infant Newborn Infant General Medicine Clinical Enzyme Tests medicine.disease Cystic fibrosis transmembrane conductance regulator Pancreatic Function Tests Endocrinology Child Preschool biology.protein business |
| Zdroj: | The Lancet. 350:1001 |
| ISSN: | 0140-6736 |
| DOI: | 10.1016/s0140-6736(97)24040-7 |
| Popis: | pancreatic insufficient. The remaining three children with cystic fibrosis had normal elastase levels and were pancreatic sufficient; two of them had one copy each of the 3849+10kbC→T mutation; the full genotype of the third child was undetermined. The 3849+10kbC→T mutation had already been associated with less severe disease and may result in the presence of small amounts of normal cystic fibrosis transmembrane conductance regulator (CFTR). Cystic fibrosis is a heterogenous disorder and the rare milder mutations associated with pancreatic sufficiency will not necessarily be detected by elastase testing. The samples of meconium passed by three neonates following surgery for meconium ileus all showed zero activity. These children had longitudinal testing over the subsequent 3 weeks during which period the concentration of elastase remained consistently zero. All three neonates were homozygous for the ∆F508 mutation. A survey of 145 meconium stools in normal neonates showed a mean elastase concentration of 63·9 (7·2) μg and demonstrated that levels rose rapidly to above 200 μg during the first month of life. Others have shown that stool elastase levels in premature and term neonates reached normal adult reference concentration by 2 weeks of age. This study has shown the measurement of stool elastase to be a simple and non-invasive test for exocrine pancreatic function in children with cystic fibrosis across a broad range of genotypes. Faecal pancreatic elastase is stable for a week at room temperature and for months at 4oC, making handling and postage of a small stool sample straightforward. The observation of zero activity in three meconium samples of children subsequently shown to have cystic fibrosis by genotyping highlights the potential role that this assay may play as a screen test in neonates. |
| Databáze: | OpenAIRE |
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