Reliable screening for acute pancreatitis with rapid urine trypsinogen-2 test strip

Br J Surg. 2000 Jan;87(1):49-52. doi: 10.1046/j.1365-2168.2000.01298.x.

Abstract

Background: This study was designed to evaluate the validity of a new rapid urinary trypsinogen-2 test strip (Actim Pancreatitis) for detection of acute pancreatitis in patients with acute abdominal pain.

Methods: A total of 525 consecutive patients presenting with abdominal pain at two emergency units was included prospectively and tested with the Actim Pancreatitis test strip. Urine trypsinogen-2 concentrations were also determined by a quantitative method. The diagnosis and assessment of severity of acute pancreatitis was based on raised serum and urinary amylase levels, clinical features and findings on dynamic contrast-enhanced computed tomography.

Results: In 45 patients the diagnosis of acute pancreatitis could be established. The Actim Pancreatitis test strip result was positive in 43 of them resulting in a sensitivity of 96 per cent. Thirty-seven false-positive Actim Pancreatitis test strips were obtained in patients with non-pancreatic abdominal pain resulting in a specificity of 92 per cent. Nine patients with severe acute pancreatitis were all detected by the dipstick.

Conclusion: A negative Actim Pancreatitis strip result excludes acute pancreatitis with high probability. Positive results indicate the need for further evaluation, i.e. other enzyme measurements and/or radiological examinations. The test is easy and rapid to perform, unequivocal in its interpretation and can be used in healthcare units lacking laboratory facilities.

MeSH terms

  • Abdominal Pain / etiology
  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / urine
  • Clinical Enzyme Tests*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatitis / diagnosis*
  • Prospective Studies
  • Sensitivity and Specificity
  • Trypsin*
  • Trypsinogen / urine*

Substances

  • Biomarkers
  • PRSS2 protein, human
  • Trypsinogen
  • Trypsin