Medical College of Wisconsin Pediatric Gastroenterology and Nutrition Laboratory (PGNL)

The PGNL lab provides a panel of specialized functional tests for the diagnosis and treatment of gastrointestinal disorders.

The PGNL plays an integral role with the Division of Gastroenterology by delivering additional diagnostic services in the following areas: CARE (Constipation and Reflux Evaluation) Program, Celiac Disease, Eosinophilic GI Disorders, Gastrointestinal Motility, Inflammatory Bowel Disease Program, Obesity, Pancreatic disorders, Tube Feeding Clinic, Liver Disease/Transplantation and Feeding/Swallowing Disorders.

The PGNL is a CLIA certified (PDF) reference lab for the testing of intestinal disaccharidases (lactase, sucrase, glucoamylase and palatinase), pancreatic enzymes (lipase, trypsin and amylase) and stool alpha-1 antitrypsin.

Pediatric Gastroenterology and Nutrition Laboratory Requisition Form (PDF)

Recommended Protocol for Pancreatic Stimulation Test

Specimens collected via P catheter inserted through biopsy channel. Each specimen should be >0.5 ml if possible. Specimens should be placed on ice immediately, then frozen and stored at -75oC in an ultra-low freezer until ready to ship.

1. Baseline collection (T0).
2. Test dose of secretin (0.2 mcg) IV over 1 minute.
3. Full dose of ChiRhoStim® (Human Secretin for Injection) (0.2 mcg/kg) and CCK (Kinevac) (0.02 mcg/kg) IV over 1 minute. ChiRhoStim® (Human Secretin for Injection is available from ChiRhoClin, Inc. (301) 476-8388; ChiRhoStim.com
4. Specimens collected at 5, 10, 15 minutes following secretin/CCK (T5, T10, T15). We recommend using a duodenal aspiration catheter.
5. Each specimen must be at least 0.2 ml.
6. We will interpret results when samples are obtained as outlined in this protocol. If the protocol is not followed, we will continue to provide the results of pancreatic enzyme measurements but will be unable to interpret results.

Normal Values for individual pancreatic enzymes*:

• Lipase > 146.0 moles/ml/min.
• Amylase > 32.0 moles/ml/min.
• Trypsin > 55.4 nmoles/ml/min.

*Pancreatic function can only be considered as normal when the pre-stimulated or 1 of the post-stimulated aspirates (usually 5-10 mins) attains respective levels of activity as indicated.