The clinical diagnosis of cystic fibrosis of the pancreas, especially before the appearance of the associated pulmonary lesions, presents real difficulties. Experience has shown that the infection of the respiratory tract, once well established, does not often yield to treatment. A means of confirming the diagnosis in suspected cases would make it possible to attempt early dietary and vitamin therapy with some hope of success. Theoretically, the most direct method of diagnosis of pancreatic deficiency would be the assay of the pancreatic enzymes in the duodenal juice. On anatomic grounds one would expect the enzymes to be absent or of low concentration in all infants with pancreatic fibrosis and present in all other infants, with or without the celiac syndrome. However, the clinical similarity between cases of pancreatic fibrosis and cases of the celiac syndrome without anatomic change in the pancreas suggests the possibility of a functional change in the
ANDERSEN DH. PANCREATIC ENZYMES IN THE DUODENAL JUICE IN THE CELIAC SYNDROME. Am J Dis Child. 1942;63(4):643–658. doi:10.1001/archpedi.1942.02010040011001
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