Fecal elastase-1 and ultrasonography for assessment of exocrine pancreatic function in children with cystic fibrosis | ||||
| Zagazig University Medical Journal | ||||
| Article 47, Volume 30, Issue 4, July and August 2024, Page 1484-1494 PDF (1.22 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2024.273764.3216 | ||||
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| Authors | ||||
Dina Tawfeek Sarhan   1; Hanan Sameer2; Sameh Saber Hegab3; Aya Mahdy Abd-Allah4; Khalid Mohamed Salah5
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| 1Pediatrics department, faculty of medicine, Zagazig university, Egypt | ||||
| 2Department of Clinical Pathology, Faculty of Medicine - Zagazig University, Egypt. | ||||
| 3Radiology department, Faculty of Medicine, Zagazig University, Zagazig, Egypt | ||||
| 4Resident of Pediatrics, Zgazig General Hospital, Ministry of health, Egypt. | ||||
| 5Pediatrics department, Faculty of Medicine, Zagazig University, Zagazig, Egypt | ||||
| Abstract | ||||
| Background: Cystic fibrosis (CF) is an autosomal recessive disorder affecting the exocrine functions of many organs including the pancreas. Clinical and laboratory recognition of pancreatic insufficiency is important for proper treatment. Early radiologic detection of pancreatic pathologic changes can help better evaluation. Objectives: To correlate exocrine pancreatic function with pancreatic ultrasound changes in CF children. Methods: This was a prospective cross-sectional study to assess the exocrine pancreatic function by measuring fecal elastase-1 (FE-1) level and doing pancreatic ultrasound for CF patients. Results: A total of 30 CF patients with age range from 3 months to 10 years were included in the study. They were categorized into three age groups; below one year, from 1 to 4 years and above 4 years old. None of our cases was exocrine pancreatic sufficient regarding FE-1 level and most of them (86.7%) had severe fecal elastase deficiency. Before 1 year of age there was no detected abnormal ultrasound findings in pancreas; only 8 older patients had abnormal US detected as hyper-echogenicity of pancreas. Abnormal US was more detected among patients with severe pancreatic insufficiency. The sensitivity of ability of fecal elastase level to predict abnormal ultrasound was 80%, with 84% specificity at cut of point 15.2 µg/g. Conclusions: Fecal-elastase-1 measurement in cystic fibrosis children can diagnose the exocrine pancreatic insufficiency even without clinical manifestations of steatorrhea. FE-1 level can predict pathologic changes of pancreas detected by transabdominal ultrasound. | ||||
| Keywords | ||||
| Cystic fibrosis; pancreatic insufficiency; ultrasound; fecal elastase | ||||
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