Detection and follow up of exocrine pancreatic insufficiency in cystic fibrosis: a review

Pancreatic function testing is particularly difficult when the degree of re maining function has to be quantified. Detection of pancreatic insufficienc y can suggest the diagnosis of cystic fibrosis (CF). It is, however; also i mportant to follow the degree of pancreatic insufficiency in CF since its f unction can decline with age. Adaptation of pancreatic enzyme replacement t herapy on residual function is necessary. Different tests with their advant ages and disadvantages are critically reviewed in this article with respect to specificity, sensitivity, performance and cost-effectiveness. Conclusion Elastase-1 detection in faeces is probably the easiest test for the detection of pancreatic insufficiency in cystic fibrosis. For clinical follow-up tests, measuring the fat assimilation such as steatocrit and brea th tests are more suited.