fecal elastase

Question

I would like to ask if any special preperation is necessary in order to examine the fecal elastase in a child? Is it a necessary test in a child with negative sweat test, but with low weight and height and with bronchial asthma? The mother is negative for CF mutations.

Answer

Dear friend,
For the fecal elastase test there is no special preparation necessary.
The low values of fecal elastase are an indication of pancreatic insufficiency. Because the most common cause of pancreatic insufficiency in young children is Cystic Fibrosis, indirectly these low values may point to CF, but a diagnosis of CF cannot be based solely on this test. This test is used to diagnose pancreatic insufficiency in children who do not gain weight and have smelly, fatty and big feces.
Furthermore, round 15% of CF patients have normal pancreatic function, therefore the elastase values will be within normal limits.
When the sweat test has been performed in a standardized way in an experienced center and is clearly negative, CF has been excluded and there is no need to check the fecal elastase.

Yours friendly,
Dr. Stavros Doudounakis

24.08.2012