Document Detail


A Comparison of Diagnostic Methods for Pancreatic Insufficiency in Infants with Cystic Fibrosis.
MedLine Citation:
PMID:  22922373     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: The objective of this study is to compare daily weight gain and laboratory analysis (72-hour fecal fat and steatocrit) to fecal elastase-1 (EL-1) when diagnosing pancreatic insufficiency in infants with cystic fibrosis. METHODS:: Thirty-nine infants with cystic fibrosis, diagnosed consecutively by newborn screening at 2 referral centers, were included in the study. Daily weight gain and results of laboratory analysis of stool samples were compared using the Kappa coefficient and the receiver operator characteristic (ROC) curve. RESULTS:: Using the criterion of low daily weight gain, the frequency of PI was 92.3%; using the 72-hour fecal fat, steatocrit, and fecal EL-1 tests, the frequency was 42.3%, 86.2%, and 84.6%, respectively. EL-1 was used as the reference test. It was observed that the criteria of low daily weight gain (less than the 50 percentile) and abnormal steatocrit, used together, showed the highest sensitivity (91.3%) and specificity (83.3%) for the diagnosis of PI. CONCLUSIONS:: When fecal EL-1 analysis is not immediately available, low daily weight gain associated with abnormal steatocrit can be adopted as a criterion for initiating pancreatic enzyme replacement therapy in infants with cystic fibrosis. However, EL-1 testing should be performed later for confirmation of PI.
Authors:
Amanda C S Tardelli; Paulo A M Camargos; Francisco J Penna; Pauliane F B Sarkis; Elizabet V Guimarães
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-23
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Biochemist, University Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil. †Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil; Senior Visiting Professor, Health Sciences Center, Federal University of São João del-Rei, Divinópolis, Brazil ‡Department of Pediatrics, Diagnostic Support Action and Research Center (NUPAD)/Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil §Department of Pediatrics, Diagnostic Support Action and Research Center (NUPAD)/Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil ||University Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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