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Test Category: Specialist Biochemistry

Investigation Name:Faecal Human Pancreatic Elastase

Accreditation:Faecal Elastase

Intro:

The exocrine function of the pancreas is to synthesise, store and secrete alkaline, bicarbonate-rich fluids containing various enzymes essential for normal digestion. Loss of exocrine pancreatic function leads to maldigestion and malabsorption, and is seen in conditions such as acute pancreatitis, chronic pancreatitis, pancreatic cancer and cystic fibrosis. Faecal elastase (FE-1) is a serine-protease synthesised by the pancreatic acinar cells along with other pancreatic digestive enzymes. Under physiological conditions, its concentration in pancreatic juice accounts for approximately 6% of all secreted pancreatic enzymes. In contrast to most of the other pancreatic enzymes, FE-1 is stable during intestinal passage. Its concentration in stool is five to six times that determined in pancreatic juice, reflecting exocrine pancreatic function. The FE-1 assay is a simple, non-invasive test offered for the investigation of pancreatic exocrine insufficiency. It has been shown to correlate well with other direct an

Requestable Seperately?No

Units:µg/g Stool

Expected Turnaround Time:7 working days

Test Code:ELA, ELAS

Sample Type:

Random stool sample collected into a suitable container

Complex Reference Range:Normal >200 µg/g Stool Moderate-mild exocrine pancreatic insufficiency 100 – 200 µg/g Stool Severe exocrine pancreatic insufficiency <100 µg/g Stool

Collection Conditions / Other Information:First class post at ambient temperature

Referred to Another Laboratory?No

Storage Requirements:Storage requirements: Faecal elastase is stable in faeces at room temperature 5 days and for 1 month stored at 4C. If a sample is noted to be >14 days old on receipt, the sample will still be analysed, but results should be interpreted with caution NB some discrepant information – Ellis audit

Posting Address / Requirements:Russels Hall Hospital Clinical Biochemistry Department Pensnett Road Dudley DY1 2HQ

NPEX / PDF Reporting Available:Yes

EQA Scheme:UK NEQAS Scheme for Faecal Pancreatic Elastase

Further information:It may take up to day 3 of life in term infants, and up to day 14 if <28 weeks gestation, to reach normal Faecal Elastase-1 levels. Repeat testing is recommended to confirm insufficiency detected before this time. Faecal Elastase-1 levels in meconium are typically low and this sample type is not recommended.

Email Address For Chasing Results:dgft.biochemsitry@nhs.net

Methodology:The ELISA plate is coated with a monoclonal antibody, which is specific for human pancreatic elastase 1 (E1). E1 present in samples binds to this antibody and is immobilised on the ELISA plate. A complex of monoclonal anti-E1 biotin and peroxidise (POD)-Streptavidin is added which binds to the E1. Substrate solution is then added containing ABTS (2, 2’-Azino-bis-(3-ethylbenzothiazolin-6-sulfonic acid) diammonium salt), which is oxidised by the peroxidase, turning dark green. The concentration of oxidised ABTS produced is then determined photometrically (dual wavelength λ= 405 and 492 nm) and is directly proportional to the FE-1 concentration of the sample.

UKAS Reference Number:8407

Site Sample Tested:Clinical Chemistry Laboratory -Russells Hall Hospital

Cost:Email : bcpspathology.info@nhs.net for further details

Contact Number:Tel: 01384 456 111 ex 2482