lactoferrin and Exocrine-Pancreatic-Insufficiency

Most abdominal disorders present with a limited number of overlapping symptoms. Blood tests are not routinely available for use in diagnosis and so investigation tends to require complex imaging procedures or endoscopy and biopsy. These are invasive for the patient, may be associated with morbidity and mortality and have considerable resource implications. Biochemical tests on a single sample of faeces are therefore a valuable alternative. Measurement of faecal calprotectin has been shown to have a role in the diagnosis of inflammatory bowel disease and in its monitoring. Lactoferrin is also of benefit used in this way. Faecal elastase has been demonstrated to be of use in the diagnosis of pancreatic insufficiency. A number of faecal markers have been explored in colorectal cancer. Faecal occult blood testing is used for population screening, but the metabolomic marker tumour, M2-pyruvate kinase, has potential for use in both diagnosis and screening. DNA testing has advantages in colorectal cancer but the exact applications of such tests require further evaluation.

Topics: Biomarkers; Carcinoma; Colorectal Neoplasms; Enzyme-Linked Immunosorbent Assay; Exocrine Pancreatic Insufficiency; Feces; Humans; Inflammatory Bowel Diseases; Lactoferrin; Leukocyte L1 Antigen Complex; Mass Screening; Metabolome; Occult Blood; Pancreatic Elastase; Pancreatitis; Pyruvate Kinase; Sensitivity and Specificity

Pancreatic function was measured by duodenal aspiration after injection of secretin and cholecystokinin in malnourished children from Dakar and Abidjan, West Africa, and in age- and sex-matched control subjects from Dakar, Abidjan, and Marseille, France. Compared with French control subjects, pancreatic function was moderately decreased in Abidjan control subjects and more severely in Abidjan subjects with kwashiorkor. Pancreatic insufficiency was as severe in patients as in control subjects in Dakar. After a well-balanced diet was fed for 5 d, all kwashiorkor symptoms disappeared. In Abidjan pancreatic secretion levels increased but remained lower than in control subjects. After 28 d feeding, the pancreatic secretion of kwashiorkor patients in Dakar was not modified. Pancreatic extracts had no effect on changes in pancreatic insufficiency after feeding. In West Africa there is a latent pancreatic insufficiency involving water, electrolytes, and enzymes, which is more severe in Dakar, where, in contrast to Abidjan, it is neither aggravated by kwashiorkor nor corrected by feeding.

Topics: Blood Glucose; Calcium; Child, Preschool; Exocrine Pancreatic Insufficiency; Humans; Infant; Kwashiorkor; Lactoferrin; Nutritional Status; Pancreas