Faecal Elastase I. Assessment – Its Use in Diagnosis of Chronic
Krechler T., 1Kocna P., 1Vaníčková Z., Švestka T., Lukáš M., 2Doseděl J., 3Kohout P., Žák A.
IV. interní klinika 1. LF UK a VFN, Praha 1Ústav klinické biochemie a laboratorní diagnostiky 1. LF UK, Praha 2Nemocnice U Milosrdných sester sv. Karla Boromejského, Praha 3Fakultní Thomayerova nemocnice 1. LF UK, Praha
Background. The diagnosis of chronic pancreatitis is based on the imaging methods. These imaging methods show
the main morphological changes in the pancreatic ducts and its parenchyma, but they do not define the function of
the pancreas. The aim of our study was Faecal Elastase I. determination in patients with chronic pancreatitis. The test
is a simple, non-invasive method of the investigation of the pancreatic exocrine insufficiency. The Faecal Elastase
I occurring in the stool was correlated with the level of the damage of pancreatic tissue together with the control group
of the patients with different diagnoses.
Methods and Results. Faecal Elastase I (mean values in ug/g of stool) detection is a simple, non-invasive method
which correlates well with the damage of pancreatic tissue, stemming from chronic pancreatitis. This test is
routinely used especially in the diagnosis of chronic pancreatitis. The classification of chronic pancreatitis
currently depends on the morphological changes of the pancreatic duct system (the patho-morphological
changes). We are currently missing the classification describing simultaneously the morphological changes of the
gland and the function of the pancreas. In our studies we have used a newly proposed classification system, which
was put together in Bern, 2000 (1). This new system encompasses morphological and functional changes. Faecal
Elastase I was determined by a microplate ELISA method using monoclonal antibody to human pancreatic
protein. The Faecal Elastase I. was tested in the stool of the 196 patients with chronic pancreatitis stemming from
alcoholism. The occurrence of Faecal Elastase I. was classified according to the levels assigned by the
classification system. The control group used in this study included 144 patients with different diagnoses. The
results demonstrate a very good correlation of Faecal Elastase I. with the grading of the newly proposed
classification system of chronic pancreatitis. Patients with the highest levels of the damage of the pancreas had
a significantly lower occurrence of Faecal Elastase I. in comparison with the non-pancreatic control group and in
patients with chronic pancreatitis who had no clinical complications or damage of endocrine and exocrine
functions of the pancreas.
Conclusions. Feacal Elastase I performance plays an important role in diagnosing of the severe cases of chronic
pancreatitis and in the follow-up of the chronic pancreatitis in the patients with the intermediate damage of the
chronic pancreatitis, functional tests, Faecal Elastase I.