Utility of a noninvasive urine-based test for diagnosing acute pancreatitis in children

Pediatric acute pancreatitis (AP) is a growing clinical concern with a wide spectrum of severity, from mild episodes to life-threatening conditions. Traditional diagnostic methods primarily rely on serum amylase and lipase measurements, which are invasive and can be challenging in children. This study is the first to evaluate the diagnostic accuracy of the urine trypsinogen-2 dipstick test (UTDT) as a noninvasive test for diagnosing pediatric AP.

This prospective study included 28 pediatric patients (31 episodes) presenting with acute abdominal pain at a tertiary medical center from November 2022 to October 2024. AP was diagnosed based on the International Study Group of Pediatric Pancreatitis: In Search for a Cure (INSPPIRE) criteria. Urine samples were collected either within the first 24 hours (h) or later during hospitalization. UTDT sensitivity and specificity were calculated and compared to serum amylase and lipase levels.

Of the 31 episodes, 19 (61%) were confirmed as AP, and 12 (39%) were attributed to other causes. The UTDT had an overall sensitivity of 68% and specificity of 100%. Sensitivity increased to 87% when urine samples were collected within 24 h of admission. In non-AP cases, UTDT consistently produced negative results, with the high specificity supporting its reliability in distinguishing AP from other conditions.

The UTDT demonstrates promise as a rapid, noninvasive diagnostic tool for pediatric AP, particularly when used early in the disease course. Its high specificity and ease of use suggest that it may serve as an alternative to invasive blood tests once validated through larger-scale studies. Further research is needed to confirm these findings and establish the role of UTDT in clinical practice.