Now that fecal elastase is available in the United States, should clinicians start using it?

Lankisch, P. G.

doi:10.1007/s11894-004-0039-9

Cited by 26 publications

(19 citation statements)

References 40 publications

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“…There is, however, considerable concern of the overall accuracy of FE-1 in diagnosing PEI, as it is known that it correlates poorly to CFA [35,36,37]. The present study is therefore of particular importance as we found no statistical association between the CFA and the FE-1 test even with generous statistical manipulations to deal with potentially confounding factors.…”

Section: Discussionmentioning

confidence: 53%

Partial Pancreatic Resection for Pancreatic Malignancy Is Associated with Sustained Pancreatic Exocrine Failure and Reduced Quality of Life: A Prospective Study

et al. 2011

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Section: Discussionmentioning

confidence: 53%

Partial Pancreatic Resection for Pancreatic Malignancy Is Associated with Sustained Pancreatic Exocrine Failure and Reduced Quality of Life: A Prospective Study

et al. 2011

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“…200 g/ g stool [23][24][25][26] . The sensitivity of fecal elastase test is closely related to the severity of the pancreatic insufficiency [24,25] . Despite an insufficient sensitivity in mild or moderate pancreatitis, 23 patients in the whole cohort (30%) presented with decreased fecal test, this rate being significantly more frequent in patients belonging to group P (p = 0.04) ( table 3 ).…”

Section: Discussionmentioning

confidence: 99%

Frequency and characteristics of pancreatitis in patients with inflammatory bowel disease

Barthet

Lesavre

Desplats³

et al. 2006

Pancreatology

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“…Nondiabetic children carrying a CEL mutation were investigated because their pancreas were presumably not yet affected by the insulinopenic effects of diabetes. Finding an early structural marker for this disease might offer insight into the pathogenetic process and serve as an alternative to the biochemical marker fecal elastase, which can be unreliable in cases of moderate pancreatic dysfunction (15). We applied ultrasound and magnetic resonance imaging (MRI) to provide a radiation-free radiological investigation of the pancreas.…”

mentioning

confidence: 99%

Pancreatic Lipomatosis Is a Structural Marker in Nondiabetic Children With Mutations in Carboxyl-Ester Lipase

et al. 2007

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Both pancreatic volume reduction and lipomatosis have been observed in subjects with diabetes. The underlying molecular and pathological mechanisms are, however, poorly known, and it has been speculated that both features are secondary to diabetes. We have recently described pancreatic atrophy and lipomatosis in diabetic subjects of two Norwegian families with a novel syndrome of diabetes and exocrine pancreatic dysfunction caused by heterozygous carboxyl-ester lipase (CEL) mutations. To explore the early pathological events in this syndrome, we performed radiological examinations of the pancreas in nondiabetic mutation carriers with signs of exocrine dysfunction. In a case series study at a tertiary hospital, we evaluated 11 nondiabetic and mutation-positive children with fecal elastase deficiency and 11 age-and sex-matched control subjects using ultrasound and magnetic resonance imaging (MRI) to estimate pancreatic fat content. The pancreata of nondiabetic mutation carriers exhibited increased reflectivity on ultrasound and had MRI findings indicative of lipomatosis. Apparently, carriers of heterozygous CEL mutations accumulate fat in their pancreas before the anticipated development of diabetes. Our findings suggest that lipomatosis of the pancreas reflects early events involved in the pathogenesis of diabetes and exocrine pancreatic dysfunction syndrome. Diabetes 56: 444 -449, 2007 T he pancreas consists of acinar and ductal cells with the islets of Langerhans scattered within the exocrine tissue. ␤-Cells, which are central in the development of diabetes, constitute the major part of the islets (1). There are reports in diabetic subjects of pathological changes involving not only the islets but the entire pancreatic gland, such as pancreatic volume reduction (2-8) and lipomatosis (fatty infiltration) of the pancreas (9,10). The lipomatosis reported in autopsy studies has been described as patchy intralobular or perilobular areas of fat replacement of pancreatic parenchyma (9,10). Pancreatic size reduction and lipomatosis have been discussed as possible secondary events involved in atrophy and lipomatosis related to diabetes due to a reduced insulinotropic effect on the acinar cells (11-13). The underlying molecular and pathophysiological mechanisms are, however, poorly known. Monogenic pancreatic diseases could cast important light on early pathological events and provide the opportunity to study subjects before the development of diabetes.We recently described pancreatic atrophy and lipomatosis in diabetic subjects of two Norwegian families with a novel syndrome of diabetes and pancreatic exocrine dysfunction (MODY8; OMIM [Online Mendelian Inheritance in Man] no. 609812) caused by heterozygous carboxyl-ester lipase (CEL) mutations (14). In that report, computerized tomography of the pancreas was performed in adult mutation carriers, and most of the studied subjects were already diabetic. We hypothesized that the morphologic abnormalities of the pancreas that were identified, particularly the lipomatosis,...

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Now that fecal elastase is available in the United States, should clinicians start using it?

Cited by 26 publications

References 40 publications

Partial Pancreatic Resection for Pancreatic Malignancy Is Associated with Sustained Pancreatic Exocrine Failure and Reduced Quality of Life: A Prospective Study

Partial Pancreatic Resection for Pancreatic Malignancy Is Associated with Sustained Pancreatic Exocrine Failure and Reduced Quality of Life: A Prospective Study

Frequency and characteristics of pancreatitis in patients with inflammatory bowel disease

Pancreatic Lipomatosis Is a Structural Marker in Nondiabetic Children With Mutations in Carboxyl-Ester Lipase

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