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Evidence summaries

Urine Trypsinogen-2 Dipstick Test in the Diagnosis of Acute Pancreatitis

A negative result of urine trypsinogen-2 dipstick test appears to rule out acute pancreatitis. Level of evidence: "B"

The urine trypsinogen-2 dipstick test was compared in 500 consequtive emergency department patients with acute abdominal pain to quantitative urine trypsinogen-2 measurement, serum and urine amylase and urine amylase dipstick test 1. Trypsinogen-2 dipstick test was positive in 50/53 patients with acute pancreatitis diagnosed according to standardized criteria (sensitivity 93%) and in 21/447 patients without acute pancreatitis (specificity 95%), with a cutoff value of 50 µg/l per liter for the upper reference limit). The sensitivity and specificity were superior to serum amylase (85% and 91%, with a cutoff value of 300 U per liter for the upper reference limit) or urine amylase dipstick test (83% and 88%, with a cutoff value of 2000 U per liter for the upper reference limit).

Comment: The quality of evidence is downgraded by imprecise results (limited study size).

    References

    • Kemppainen EA, Hedström JI, Puolakkainen PA, Sainio VS, Haapiainen RK, Perhoniemi V, Osman S, Kivilaakso EO, Stenman UH. Rapid measurement of urinary trypsinogen-2 as a screening test for acute pancreatitis. N Engl J Med 1997 Jun 19;336(25):1788-93. [PubMed]

Primary/Secondary Keywords