Immunoreactive trypsin levels in neonates with meconium ileus

Area of Science:

• Neonatal screening
• Pediatric gastroenterology
• Biochemistry

Background:

• Serum immunoreactive trypsin (IRT) is a key neonatal screening test for cystic fibrosis (CF).
• IRT levels can vary in healthy and CF neonates within the first weeks of life.
• Meconium ileus (MI) complicates approximately 15% of CF cases.

Purpose of the Study:

• To investigate serum IRT levels in neonates with CF presenting with MI.
• To compare IRT levels between neonates with simple and complicated MI.
• To compare IRT levels in CF neonates with MI against non-CF controls.

Main Methods:

• Sequential measurement of serum IRT levels in neonates with CF and MI (n=29).
• Comparison of IRT levels with non-cystic neonates/controls with intra-abdominal pathologies (n=49).
• Analysis of IRT levels based on MI complexity, surgical intervention, and clinical parameters.

Main Results:

• IRT levels were significantly higher in the CF-MI group compared to non-cystic controls (P < 0.001).
• No significant difference in IRT levels was found between simple and complicated MI groups.
• No significant differences were observed in IRT levels based on surgical intervention, pre/post-operative status, birth weight, or gestation.

Conclusions:

• Serum IRT levels are significantly elevated in neonates with CF and MI compared to non-cystic controls without MI.
• A single elevated IRT level in a neonate should prompt CF analysis, even in the presence of surgical pathology.