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[Fecal elastase-1: a useful test in pediatric practice]
L David-Henriau1, S Bui, I Molinari
1Unité de gastroentérologie pédiatrique, département de pédiatrie, centre hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux cedex, France.
Insights
Fecal elastase-1 (E1F) is a useful non-invasive tool for diagnosing pancreatic insufficiency in children. However, low E1F levels can also occur in other digestive conditions like celiac disease.
Area of Science:
- Pediatric Gastroenterology
- Digestive Disease Diagnostics
- Biomarker Analysis
Background:
- Pancreatic insufficiency diagnosis in children can be challenging.
- Non-invasive markers are needed for accurate pediatric diagnosis.
Purpose of the Study:
- To evaluate fecal elastase-1 (E1F) and chymotrypsin (ChT) for diagnosing pancreatic insufficiency in pediatric patients.
- To compare E1F and ChT performance across different pediatric digestive disease groups.
Main Methods:
- Stool samples from 198 children were analyzed.
- Children were categorized into three groups: healthy, pancreatic disease, and non-pancreatic digestive disease.
- Fecal elastase-1 (E1F) and chymotrypsin (ChT) levels were measured.
Main Results:
- Fecal elastase-1 (E1F) was significantly low in children with pancreatic diseases.
- Normal chymotrypsin (ChT) levels were observed in some children with pancreatic insufficiency, especially those on enzyme therapy.
- Decreased E1F levels were noted in a subset of children with non-pancreatic digestive diseases, including acute gastroenteritis and celiac disease.
Conclusions:
- Fecal elastase-1 (E1F) is a valuable, non-invasive diagnostic tool for pancreatic insufficiency in children presenting with growth failure, chronic diarrhea, or cystic fibrosis.
- Low E1F values should be interpreted cautiously, as they can also be present in conditions characterized by villous atrophy or very liquid stools.
Aim:
To study fecal elastase-1 (E1F) and chymotrypsin (ChT) in stools for the diagnosis of pancreatic insufficiency in pediatric practice.
Materials And Methods:
E1F and ChT were measured in stools of 198 children divided in 3 groups: 49 children without any digestive disease (group A), 71 children with pancreatic diseases (group B), and 78 children with non-pancreatic digestive diseases (group C).
Results:
In group B, E1F values were very low in 64 children and normal in 7 children without pancreatic insufficiency (6 children with cystic fibrosis and 1 with chronic pancreatitis). ChT values were normal in children without pancreatic insufficiency but also in half of children treated with pancreatic enzymes. Decreased E1F values were seen in 2 children (4%) in the group A and 22 children (28%) in the group C, especially those with acute gastroenteritis or celiac disease.
Conclusion:
E1F is a simple, non-invasive, useful tool for the diagnosis of pancreatic insufficiency in children with growth failure or chronic diarrhea, and those with cystic fibrosis. Nevertheless, low values may be found in diseases with villous atrophy or very liquid stools.
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