Elastase is a pancreatic enzyme that digests and degrades a number of proteins. A finding of low elastase in a formed stool specimen is an indicator of pancreatic exocrine insufficiency. Moderate pancreatic insufficiency is defined at 100-200 μg/mL, and severe pancreatic insufficiency as <100 μg/mL. Fecal elastase can be artefactually low due to fluid dilution effects in a loose/watery stool sample. Check the
reported consistency of the stool specimen.
Fecal elastase measured by a sensitive immunoassay is a specific marker for pancreatic function and maintains a high diagnostic accuracy among patients with small intestinal diseases. This elastase marker allows for the diagnosis or exclusion of pancreatic exocrine insufficiency and degree of severity, which can be caused by chronic pancreatitis, cystic fibrosis, pancreatic tumor, cholelithiasis or diabetes mellitus.
This test does not differentiate between pancreatic insufficiency due to chronic pancreatitis and that due to pancreatic cancer. Immunoreactive elastase concentrations are similar for children and adults. In cases of severe exocrine pancreatic insufficiencies, fecal fat stain may also be elevated. Supplementation with pancreatic enzymes, minerals, and vitamins may be warranted.
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