Comparing acid steatocrit and faecal elastase estimations for use in M-ANNHEIM staging for pancreatitis

Kamath, Ganesh M and Pai, Ganesh C and Kamath, Asha and Kurien, Annamma (2017) Comparing acid steatocrit and faecal elastase estimations for use in M-ANNHEIM staging for pancreatitis. World Journal of Gastroenterology, 23 (12). pp. 2217-2222. ISSN 1007-9327

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Abstract

Aim :To compare two tests for exocrine pancreatic function (EPF) for use in M-ANNHEIM staging for pancreatitis. Methods: One hundred and ninety four consecutive patients with acute pancreatitis (AP; n = 13), recurrent acute pancreatitis (RAP; n = 65) and chronic pancreatitis (CP; n = 116) were enrolled. EPF was assessed by faecal elastase-1 (FE-1) estimation and stool fat excretion by the acid steatocrit method. Patients were classified as per M-ANNHEIM stages separately based on the results of the two tests for comparison. Independent Student’s t -test, χ 2 test, Kruskal-Wallis test, Mann-Whitney U test and McNemar’s test were used as appropriate. Results: Sixty-one (52.5%) patients with CP had steatorrhoea when assessed by the acid steatocrit method; 79 (68.1%) with CP had exocrine insufficiency by the FE-1 test (χ 2 test, P < 0.001). The results of acid steatocrit and FE-1 showed a significant negative correlation (Spearman’s rho = -0.376, P < 0.001). A statistically significant difference was seen between the M-ANNHEIM stages as classified separately by acid steatocrit and the FE-1. Thirteen (6.7%), 87 (44.8%), 89 (45.8%) and 5 (2.5%) patients were placed in M-ANNHEIM stages 0, Ⅰ, Ⅱ, and Ⅲ respectively, with the use of acid steatocrit as against 13 (6.7%), 85 (43.8%), 75 (38.6%), and 21 (10.8%) respectively by FE-1 in stages 0, Ⅰ, Ⅱ, and Ⅲ thereby altering the stage in 28 (14.4%) patients (P < 0.001, McNemar’s test). Conclusion: FE-1 estimation performed better than the acid steatocrit test for use in the staging of pancreatitis by the M-ANNHEIM classification since it diagnosed a higher proportion of patients with exocrine insufficiency.

Item Type: Article
Uncontrolled Keywords: Chronic pancreatitis; Pancreatic function tests; Pancreatic elastase; Staging; Steatorrhoea.
Subjects: Medicine > KMC Manipal > Community Medicine
Medicine > KMC Manipal > Gastroenterology
Medicine > MMMC Manipal > Pathology
Medicine > MMMC Manipal > Physiology
Depositing User: KMC Library
Date Deposited: 04 Apr 2017 03:36
Last Modified: 04 Apr 2017 03:36
URI: http://eprints.manipal.edu/id/eprint/148638

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