Specimen Collection
Please send sample on ice or frozen.
Separate sample is required if other faecal tests are requested.
4 mg Collect Faeces (Always Required)
Reference Intervals
|
> =200 ug/g
|
Not suggestive of exocrine pancreatic insufficiency especially in those with low pre-test probability (e.g. in those suspected of irritable bowel syndrome with diarrhoea). In those with high pre-test probability (e.g. those with chronic pancreatitis or cystic fibrosis), around 10% with mild exocrine pancreatic insufficiency may be missed.
|
|
100 - 199 ug/g
|
Borderline result. It can reflect mild or moderate exocrine pancreatic insufficiency in those with high pre-test probability but it can also be encountered in individuals with normal pancreatic exocrine function especially with low pre-test probability
|
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<100 ug/g
|
Suggestive of moderate to severe exocrine pancreatic insufficiency.
|
Uncertainty of Measurement is 40%
Turnaround Time: Within 1 week
Assay Method
Principle: Chemiluminescent Immunoassay
Analyser: Diasorin Liaison XL
Diagnostic Use and Interpretation
Pancreatic elastase-1 is a pancreas specific protease that can be found in faeces. As its production relates to exocrine pancreatic function and is relatively resistant to gut luminal degradation, the faecal pancreatic elastase test has been used as an indirect pancreatic function marker predominantly to either rule in or rule out severe exocrine pancreatic insufficiency. Its ability to detect mild to moderate exocrine pancreatic insufficiency is considered poor to modest.
Unlike the faecal chymotrypsin test, it is not affected by faecal pH and also is not influenced by exogenous pancreatic enzyme replacement therapy. However, both tests can be affected (falsely low result) by watery stool due to dilutional effect.
In the interpretation of a faecal pancreatic elastase result, the pre-test probability should be considered in conjunction with the commonly used cut point of 200 ug/g wet stool to achieve a more desirable diagnostic performance (also see section on reference intervals).
References:
1. Leeds JS et al. The role of fecal elastase-1 in detecting exocrine pancreatic disease. Nat. Rev. Gastroenterol. HJepatol 2011; 8: 405-415. (can be accessed via:
https://ascendabio.com/wp-content/uploads/ref-docs/elastase-epi.pdf
)
2. Hart PA et al. Diagnosis of exocrine pancreatic insufficiency. Curr Treat Options Gastro 2015; 13: 347-353. (can be accessed via:
https://link.springer.com/article/10.1007/s11938-015-0057-8
)
3. Vanga RR et al. Diagnostic performance of measurement of fecal elastase-1 in detection of exocrine pancreatic insufficiency: systematic review and meta-analysis. Clinical Gasteroenterology and Hepatology 2018; 16: 1220-1228. (can be accessed via:
https://www/cghjournal.org/article/S1542-3565%2818%2930095-8/pdf
)
Contact Information
Emails to
chemicalpathologist@adhb.govt.nz
will receive priority attention from the on-call chemical pathologist.
If the query concerns a specific patient please include the NHI number in your email.
If email is not a suitable option, please contact the on-call chemical pathologist via
Lablink (Auckland City Hospital ext. 22000 or 09-3078995).
Individual chemical pathologists may be contacted but will not be available at all times.
After-hours
: contact
Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours.
Dr Samarina Musaad
(Clinical Lead)
:
SamarinaM@adhb.govt.nz
ext. 22402
Dr Cam Kyle:
CampbellK@adhb.govt.nz
ext 22052
Dr Weldon Chiu:
WeldonC@adhb.govt.nz
ext. 23427
Dr Campbell Heron:
CHeron@adhb.govt.nz
ext. 23427
Dr Sakunthala Jayasinghe:
Sakunthala@adhb.govt.nz
ext. 23427
Specimen Transport Instructions for Referring Laboratories
Please send sample on ice or frozen.
If tests other than faecal elastase are requested, a separate sample is required.