Clinical Usefulness of Dual-Label Schilling Test for Pancreatic Exocrine Function

Chen, Wenliang; Morishita, Reiji; Eguchi, Tadashi; Kawai, Takeshi; Sakai, Masahiko; Tateishi, Hiroyuki; Uchino, Haruto

doi:10.1016/s0016-5085(89)80021-6

Cited by 16 publications

(5 citation statements)

References 26 publications

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“…Malabsorption of vitamin B 12 has been observed in 30–50% of adult patients with pancreatic exocrine insufficiency 153–155 . Vitamin B 12 malabsorption occurs in pancreatic insufficiency due to the impaired degradation of R‐proteins bound to dietary vitamin B 12 156–158 . R‐proteins are non‐intrinsic factor cobalamin‐binding proteins present in saliva and gastric juice, and pancreatic proteases degrade R‐proteins and allow intrinsic factor to bind to vitamin B 12 .…”

Section: Dual‐label Schilling Testmentioning

confidence: 99%

“…The dual‐label Schilling test for pancreatic exocrine function is based on the relative absorption of R‐protein–cobalamin and intrinsic factor–cobalamin. During the test, the following are given orally to the test subject: 157 , 158 (i) [ 57 Co]cobalamin–intrinsic factor; (ii) [ 58 Co]cobalamin–R‐protein; (iii) cobinamide, a cobalamin analogue that binds only to R‐protein and serves to saturate endogenous R‐protein and prevent it from competing for [ 57 Co]cobalamin–intrinsic factor; and (iv) excess intrinsic factor to bind to [ 58 Co]cobalamin after the removal of R‐protein. Following ingestion, urine is collected for 24 h and a ratio is calculated of [ 58 Co] to [ 57 Co].…”

Section: Dual‐label Schilling Testmentioning

confidence: 99%

“…In pancreatic insufficiency, the ratio is low as [ 58 Co]cobalamin attached to R‐protein is not liberated and cannot be bound to intrinsic factor for absorption 157 ,. 158 In one study, this test showed abnormal results in 66% of patients with mild exocrine dysfunction and in 83% of patients with severe dysfunction in comparison with caerulein–secretin stimulated bicarbonate secretion 157 . One subsequent study, however, showed poor sensitivity, 159 and the test was abandoned.…”

Section: Dual‐label Schilling Testmentioning

confidence: 99%

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Pancreatic function testing

Chowdhury

Forsmark

2003

Aliment Pharmacol Ther

190

122

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SUMMARYPancreatic function tests are most commonly used to diagnose chronic pancreatitis. These tests include tests which document exocrine or endocrine gland insufficiency and tests which instead measure gradations of decreased secretory capacity. The tests in the former category generally become abnormal when advanced, longstanding chronic pancreatitis is present. Tests in the latter category, however, have the potential to detect chronic pancreatitis at an earlier stage than other available diagnostic tests, including commonly used imaging tests such as computed tomography and endoscopic retrograde cholangiopancreatography. This potential advantage of diagnostic sensitivity is, however, counterweighed by the fact that these tests which measure stimulated secretory capacity are only available at a very few referral centres. This article will review the variety of pancreatic function tests and describe their rationale, accuracy, cost, and clinical usefulness.

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Section: Dual‐label Schilling Testmentioning

confidence: 99%

Section: Dual‐label Schilling Testmentioning

confidence: 99%

Section: Dual‐label Schilling Testmentioning

confidence: 99%

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Pancreatic function testing

Chowdhury

Forsmark

2003

Aliment Pharmacol Ther

190

122

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“…Other indirect tests of pancreatic function include the tri glyceride breath tests (Loser et al, 1998) and the duallabel Schilling test (Brugge et al, 1980;Chen et al, 1989). Both tests have been the subject of numerous clinical studies, but for the most part, their sensitivity and reproducibility have been poor.…”

Section: Assessment Of Exocrine Functionmentioning

confidence: 99%

Pancreatic physiology and functional assessment

Steer¹

2012

Blumgart's Surgery of the Liver, Pancreas and Biliary Tract

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“…Although useful in diagnosing severe disease, its accuracy in diagnosing mild to moderate chronic pancreatitis is limited [45].…”

Section: Tubeless Pancreatic Function Testsmentioning

confidence: 99%

Malabsorption testing: A review

Ginsburg

Janefalkar²,

Rubin³

et al. 2000

Curr Gastroenterol Rep

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Malabsorption syndromes often present diagnostic dilemmas to even the most experienced clinicians. Several malabsorption screening tests are available, but d-xylose testing is our initial screening method of choice. Recent innovations such as serum assays for antibodies associated with celiac sprue are improving the work-up of patients with suspected malabsorption. In addition, physicians are applying technological advances in imaging to determine the underlying pathologies responsible for the occurrence of malabsorption and maldigestion. Breath testing remains a controversial modality in the work-up of patients with malabsorption. Tubeless tests of pancreatic function are also the subject of debate due to a lack of sensitivity for diagnosing mild to moderate chronic pancreatic insufficiency. This review identifies and provides critical analysis of new developments in the field of malabsorption testing. The authors also provide a clinical algorithm for diagnosing malabsorption.

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Clinical Usefulness of Dual-Label Schilling Test for Pancreatic Exocrine Function

Cited by 16 publications

References 26 publications

Pancreatic function testing

Pancreatic function testing

Pancreatic physiology and functional assessment

Malabsorption testing: A review

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