Subject(s)
Amino Acid Substitution/genetics , Cysteine/genetics , Genes, Tumor Suppressor/genetics , Glycine/genetics , Ligases , Mutation/genetics , Polymorphism, Genetic/genetics , Proteins/genetics , Tumor Suppressor Proteins , Ubiquitin-Protein Ligases , von Hippel-Lindau Disease/genetics , Humans , Italy , Von Hippel-Lindau Tumor Suppressor ProteinABSTRACT
To evaluate pancreatic exocrine function in uremia, 25 patients undergoing regular hemodialysis without clinical evidence of pancreatic disease and 25 healthy control subjects were studied by fecal elastase 1 and chymotrypsin. Abdominal ultrasonography and measurement of serum lipase, calcium, phosphate, and parathormone were also carried out. Fecal elastase was significantly lower (P < 0.001) in patients than in controls. Abnormally low values were found in 12/25 patients of whom six had values <100 microg/g. Fecal chymotrypsin was significantly lower (P < 0.05) in patients than in controls, with lower than normal values found in 10/25 patients. Fecal elastase was not related to the serum calcium, phosphate, or parathormone levels or to the period of dialysis. In patients serum lipase was normal or slightly elevated (<300 units/liter), and there was no evidence of pancreatic disease at ultrasound examination. The results lend further support to the existence of pancreatic function impairment in a significant number of patients with renal failure despite the absence of clinical and morphological evidence of pancreatic disease.
Subject(s)
Feces/chemistry , Pancreatic Elastase/analysis , Pancreatitis/diagnosis , Renal Dialysis , Uremia/complications , Aged , Aged, 80 and over , Chymotrypsin/analysis , Female , Humans , Male , Middle Aged , Pancreatic Function Tests , Reference Values , Uremia/diagnosisABSTRACT
BACKGROUND AND AIM: Available assays for measurement of pancreatic isoamylase in serum based on specific immunoinhibition of salivary fraction are unable to detect macroamylase. We combined a polyethylene glycol test which identifies macroamylase by selective precipitation with an automated assay for total amylase and pancreatic isoamylase measurement. METHODS: We analysed 24 sera proven positive for macroamylase using gel filtration chromatography and 80 negative sera. Precipitation of macroamylase with polyethylene glycol, colourimetric measurement of total amylase activity and immunoinhibition for the determination of pancreatic isoamylase were carried out. RESULTS: Macroamylasaemic sera showed precipitation of at least 71% of the amylase activity, while sera with normal-sized amylase exhibited a maximum of 61%. In all the macroamylasaemic sera but two, the immunoinhibition test showed a rise in pancreatic isoamylase, which was found to be the prevalent fraction in 16. In 21 out of 24 sera with macroamylase and 67 out of 80 with normal-sized amylase, the precipitated amylase activity was also measured after immunoinhibition of non pancreatic activity. In macroamylasaemic sera, the percentage of precipitated pancreatic isoamylase activity ranged from 75% to 98%, while in samples with normal-sized amylase it was less than 71%. CONCLUSIONS: Polyethylene glycol precipitation can easily be combined with automated assays for the determination of pancreatic isoamylase and should be carried out whenever dealing with hyperamylasaemia of unclear origin.
