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Non-specific elevation of immunoreactive trypsinogen in sick infants
D Ravine1, R I Francis, D M Danks
1Murdoch Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
European Journal of Pediatrics
|April 1, 1993
Summary
Sick infants have elevated immunoreactive trypsinogen (IRT) levels, increasing false positives in cystic fibrosis screening. Neonatal illness significantly impacts IRT, regardless of diagnosis, highlighting the need for careful interpretation of screening results.
Area of Science:
- Biochemistry
- Neonatalogy
- Genetics
Background:
- Neonatal screening programs often measure immunoreactive trypsinogen (IRT) to detect cystic fibrosis.
- Elevated IRT levels can indicate cystic fibrosis but may also be influenced by other factors.
- The impact of neonatal illness on IRT levels requires further investigation.
Purpose of the Study:
- To assess the effect of neonatal illness on immunoreactive trypsinogen (IRT) levels.
- To compare IRT values in sick infants with matched healthy controls.
- To determine if specific diagnoses in sick infants disproportionately affect IRT levels.
Main Methods:
- IRT levels were measured from dried blood spots collected on days 4-5 of life.
- Sick infants admitted to a neonatal intensive care unit were compared with matched controls.
- Sick infants were categorized by principal diagnostic groups.
Main Results:
- Sick infants exhibited significantly higher mean IRT levels (0.095 log transformed multiples of the median) compared to controls (-0.013).
- No specific diagnostic category among sick infants showed disproportionately elevated IRT levels.
- Infants with gastrointestinal abnormalities did not have higher IRT levels than other hospitalized infants.
Conclusions:
- Neonatal illness is associated with elevated IRT levels, increasing the risk of false-positive results in cystic fibrosis screening.
- IRT levels in sick infants are generally higher, irrespective of specific diagnoses, including gut abnormalities.
- These findings suggest that IRT screening results in sick neonates should be interpreted with caution due to potential elevations unrelated to cystic fibrosis.