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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bicarbonates / metabolism
  • Cystic Fibrosis / diagnosis*
  • Cystic Fibrosis / metabolism
  • Duodenum / metabolism
  • Endoscopy / methods*
  • Exocrine Pancreatic Insufficiency / diagnosis*
  • Exocrine Pancreatic Insufficiency / metabolism
  • Feces / enzymology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Elastase / metabolism
  • Pancreatic Function Tests / methods*
  • Reproducibility of Results
  • Secretin / administration & dosage
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Bicarbonates
  • Secretin
  • Pancreatic Elastase