Age-related alterations in immunoreactive pancreatic lipase and cationic trypsinogen in young children with cystic fibrosis

Cleghorn, G. J.; Benjamin, Lynne; Corey, Mary; Forstner, G.; Dati, Francesco; Durie, Peter R.

doi:10.1016/s0022-3476(85)80510-2

Cited by 27 publications

(16 citation statements)

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“…In the vast majority of infants with pancreatic insufficiency, serum trypsinogen levels were greatly elevated. This is consistent with previous data from a number of investigations (1-7) including our own (8,9). From early infancy, there was a consistent and predictable decline in serum trypsinogen in the pancreatic insufficent group, reaching subnormal values by age 5-6 yr, followed by an insignificant decline thereafter.…”

Section: Discussionsupporting

confidence: 94%

“…Between 2 and 7 yr of age this test is of little diagnostic value. After (1) first noted elevated immunoreactive pancreatic cationic trypsinogen in sera or dried-blood spots from neonates and young infants with CF, there has been considerable interest in utilizing this test to screen newborn infants for this common genetic condition (2)(3)(4)(5)(6)(7)(8)(9). In addition, a number of studies have demonstrated the application of the trypsinogen radioimmunoassay as a diagnostic tool of pancreatic dysfunction in patients with a variety of clinical disorders affecting the exocrine pancreas (9)(10)(11)(12)(13)(14).…”

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confidence: 99%

“…In addition, a number of studies have demonstrated the application of the trypsinogen radioimmunoassay as a diagnostic tool of pancreatic dysfunction in patients with a variety of clinical disorders affecting the exocrine pancreas (9)(10)(11)(12)(13)(14). As a test of pancreatic function, this approach appears to have significant age-related limitations in CF patients, due to the significant elevations of serum cationic trypsinogen in infants with pancreatic insufficiency (8,9). In older CF patients, however, we have shown that determination of circulating cationic trypsinogen is a useful method of distinguishing patients with steatorrhea due to pancreatic insufficiency from those with sufficient pancreatic function for normal fat absorption (9,10).…”

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confidence: 99%

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Age-Related Alterations of Immunoreactive Pancreatic Cationic Trypsinogen in Sera from Cystic Fibrosis Patients with and without Pancreatic Insufficiency

et al. 1986

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ABSTRACT. Serum immunoreactive cationic trypsinogen levels were determined in 99 control subjects and 381 cystic fibrosis (CF) patients. To evaluate the status of the exocrine pancreas all C F patients had previously undergone fecal fat balance studies and/or pancreatic stimulation tests. Three hundred fourteen C F patients had fat malabsorption and/or had inadequate pancreatic enzyme secretion (pancreatic insufficiency) requiring oral pancreatic enzyme supplements with meals. Sixty-seven C F patients did not have fat malabsorption and/or had adequate enzyme secretion (pancreatic sufficiency) and were not receiving pancreatic enzyme supplements with meals. Mean serum trypsinogen in 99 control subjects was 31.4 + 14.8 pg/liter ( 2 2 SD) and levels did not vary with age or sex. In C F infants (< 2 yr) with pancreatic insufficiency, mean serum trypsinogen was significantly above the non-CF values (p < 0.001). Ninety-one percent of the C F infants had elevated levels. Serum trypsinogen values in the pancreatic insufficient group declined steeply up to 5 years, reaching subnormal values by age 6. An equation was developed which described these age-related changes very accurately. Only six C F patients with pancreatic insufficiency had serum trypsinogen levels above the 95% confidence limits of this equation. In contrast, there was no age related decline in serum trypsinogen among the C F group with pancreatic sufficiency. Under 7 yr, serum trypsinogen failed to distinguish the two groups. In those over 7 yr of age, however, serum trypsinogen was significantly higher than the C F group with pancreatic insufficiency ( p < 0.001), and 93% had values within or above the control range. In conclusion, serum trypsinogen appears to be a useful screening test for C F in infancy. Between 2 and 7 yr of age this test is of little diagnostic value. After 7 yr of age, serum trypsinogen can reliably distinguish between C F patients with and without pancreatic insufficiency. (Pediatr Res 20: 209-213,1986) Abbreviation CF, cystic fibrosis

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confidence: 94%

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confidence: 99%

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confidence: 99%

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Age-Related Alterations of Immunoreactive Pancreatic Cationic Trypsinogen in Sera from Cystic Fibrosis Patients with and without Pancreatic Insufficiency

et al. 1986

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“…Unlike the pancreatic enzymes in CF patients' sera (23,(27)(28)(29), however, elevated serum mucin-associated antigen levels persisted among several adult C F patients (14). An elevated serum mucin-associated antigen level was reported in one adult CF without clinical evidence of pancreatic dysfunction (14).…”

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confidence: 95%

Serum Mucin-Associated Antigen Levels of Cystic Fibrosis Patients Are Related to Their Ages and Clinical Statuses

et al. 1989

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“…Comparative studies between quanti tative, hormonal stimulation tests and circu lating levels of pancreatic enzymes have shown that low serum cationic trypsinogen and lipase levels are indicative of severe pan creatic dysfunction [6][7][8]. Similarly, in fullterm neonates, serum lipase concentrations are below normal, but increase approxi mately threefold over the first year of life [9,10]. After 1 year of age, there is a further, but less dramatic, increase in serum lipase.…”

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confidence: 99%

The Ontogeny of Serum Immunoreactive Pancreatic Lipase and Cationic Trypsinogen in the Premature Human Infant

et al. 1988

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We evaluated the development of the exocrine pancreas in 16 healthy preterm infants (29.3 ± 1.6 weeks). The infants were fed breast milk with formula supplements (n = 8) or formula alone (n = 8). Growth was monitored weekly for 12 weeks then at 3, 6, 9, 12 months. At the same intervals sera were determined for pancreatic lipase and cationic trypsinogen. In addition, cord blood samples were analysed from another 33 preterm (27.6 ± 5.2 weeks) and 75 healthy full-term infants. Serum pancreatic lipase in the cord blood of term (3.7 ± 0.4 μg/l) and preterm infants (1.8 ± 0.2 μg/l) was significantly below values reported for older children (10.5 ± 0.9 μg/l; p < 0.001). In the preterm infant, serum lipase was also significantly lower than values obtained at term (p < 0.001). At birth, serum trypsinogen for preterm (16.8 ± 1.3 μg/l) and term infants (23.3 ± 1.9 μg/l) were below those for older children (31.4 ± 3.7 μg/l; p < 0.05). Over the first 3 weeks of life, serum lipase and trypsinogen increased significantly. From 3 weeks to 12 months of age, serum trypsinogen values remained unchanged, but serum lipase increased dramatically after 10 weeks of age. Thus, at 6 and 12 months of age, the preterm infants had significantly higher serum lipase values than infants of the same age born at term. These two pancreatic enzymes appear to show independent age-related maturation in infants born before term. The rate of maturation of lipase appears to be accelerated by exposure to the extrauterine environment.

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Age-related alterations in immunoreactive pancreatic lipase and cationic trypsinogen in young children with cystic fibrosis

Cited by 27 publications

References 20 publications

Age-Related Alterations of Immunoreactive Pancreatic Cationic Trypsinogen in Sera from Cystic Fibrosis Patients with and without Pancreatic Insufficiency

Age-Related Alterations of Immunoreactive Pancreatic Cationic Trypsinogen in Sera from Cystic Fibrosis Patients with and without Pancreatic Insufficiency

Serum Mucin-Associated Antigen Levels of Cystic Fibrosis Patients Are Related to Their Ages and Clinical Statuses

The Ontogeny of Serum Immunoreactive Pancreatic Lipase and Cationic Trypsinogen in the Premature Human Infant

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