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. 2015 Nov;44(8):1266-72.
doi: 10.1097/MPA.0000000000000425.

Diagnostic Accuracy of a Short Endoscopic Secretin Test in Patients With Cystic Fibrosis

Trond Engjom  1 , Friedemann Erchinger, Birger Norderud Lærum, Erling Tjora, Lage Aksnes, Odd Helge Gilja, Georg Dimcevski
Affiliations

Diagnostic Accuracy of a Short Endoscopic Secretin Test in Patients With Cystic Fibrosis

Trond Engjom et al. Pancreas. 2015 Nov.

Abstract

Objective: Short endoscopic secretin tests for exocrine pancreatic function are not properly evaluated in cystic fibrosis (CF).

Methods: Patients with CF and healthy controls (HCs) underwent endoscopic collection of duodenal juice between 30 and 45 minutes after secretin stimulation. Duodenal juice was analyzed for HCO3 concentration and pancreatic enzyme activities. Stool was analyzed for fecal elastase.

Results: Thirty-one patients with CF and 25 HCs were tested. Patients were classified as exocrine pancreatic sufficient (n = 13) or insufficient (n = 18). Both bicarbonate concentrations and enzyme activities in duodenal juice differentiated patients with CFI from patients with CFS and HC (P < 0.001). The population displays strong correlation between severe CF genotype in both alleles and pancreatic insufficient phenotype (P < 0.001).

Conclusions: Pancreatic exocrine insufficient CF patients could be differentiated from exocrine sufficient patients and HCs using short endoscopic secretin test.

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Figures

FIGURE 1
FIGURE 1
Inclusion flow chart.
FIGURE 2
FIGURE 2
The figure displays the examination procedure for EST.
FIGURE 3
FIGURE 3
Box and scatter plots for peak bicarbonate concentrations and peak duodenal pancreatic enzyme activities divided by groups.
FIGURE 4
FIGURE 4
The figure illustrates the correlation between peak duodenal bicarbonate concentration and duodenal lipase activity in the patients with CF. Mark especially the 2 patients with intermediate bicarbonate concentrations, aspirated volumes in the lower normal range and hyperconcentrated duodenal enzymes. White circles indicates CFI; black circles, CFS.
See this image and copyright information in PMC

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