Serum PABA and fluorescein in the course of Bz-Ty-PABA and pancreolauryl test as an index of exocrine pancreatic insufficiency

Abstract

Forty-six subjects (20 chronic pancreatitis, 7 chronic liver disease, 7 recovered from acute pancreatitis, 2 Crohn's disease, and 10 healthy controls) classified by S-C test as having normal pancreatic function (26 subjects), or moderate (10 subjects) and severe (10 cases) pancreatic insufficiency, were given, on different days, 1 g of oral PABA or 348 mg of oral fluorescein dilaurate. At the 1st, 2nd, and 4th hours (PABA) and the 2nd, 4th, and 6th hours (fluorescein) serum samples were taken for assay. In the presence of severe exocrine pancreatic insufficiency, the sensitivity of the fluorescein serum levels was higher than that observed for the PABA (100% and 80%, respectively), and quite similar to that shown by the urinary tests (100% and 70%, respectively). On the contrary, in presence of moderate pancreatic insufficiency, both the urinary test (pancreolauryl and (PABA) give a sensitivity higher than that found in the serum tests (30-40% and 10-30%, respectively). The parallel combination of both the serum or urinary tests does not significantly improve the sensitivity of the single test. These results suggest that the serum PABA and serum fluorescein tests can be valid choice when a prolonged urinary collection is difficult, i.e., in children and in elderly patients. However, the slight diagnostic gain does not justify the routine use of both urinary and serum tests.

Exocrine Pancreatic Function Tests: A Review

“…Optimal flu,irescein scrum concentrations arc found hetwcen 4 and 6 h after oral ingestion. Scrum testing seems to offer scnsnivn y and specificity similar w those o( the urine test (79,(85)(86)(87). A modified FDT with fluorescein serum determination following merocloprnmide 10 enhance g::istric emptying ,rnd secrcun stimulation appears superior w the urine test (88).…”

Exocrine Pancreatic Function in Chronic Urticaria Patients Is Normal

“…In this test the fluorescein dilaurate substrate (administered with bread and 20 g of butter) is broken down in the intestinal lumen by pancreatic aryl ester ases. The absorbed fluorescein, no longer bound to the substrate, can be assessed in the 4th h blood sample [6] and the urine [10] collected over the 10 h following oral administration of the substance. Two days later, 188.14 mg of sodium fluorescein, which does not need pancreatic digestion to be absorbed, are administered.…”

“…Urinary PABA was measured by using the DACA method [8] (normal values >49%). Serum PABA was assayed using a par tially modified version [6] of Bratton and Marshall's [9] method (normal values >3.6 gg/ml).…”

“…Both tests have been standardized [4] and their sensitivity coefficients for various lev els of digestive pancreatic insufficiency have been fairly well established and found to be good (between 70 and 100%) only for severe pancreatic insufficiencies [5,6], By measuring fecal chymotrypsin and at the same time carrying out these oral tests, a whole functional assessment of the pan creatic enzymes can be obtained. The pur pose of this study was to assess the reliability of these tests in subjects with chronic ur ticaria in whom a relationship with the digestive function, and in particular with the pancreatic function, was suspected.…”

Appropriate pancreatic function tests and indication for pancreatic enzyme therapy following surgical procedures on the pancreas

“…Several research groups have developed serum tests for the measurement of fluorescein [34][35][36][37][38]…”