The assay of duodenal fluid for the activity of the digestive pancreatic enzymes is a well-established procedure in the study of nutritional disorders in early life. In mucoviscidosis with complete pancreatic insufficiency lipase, amylase, protease, chymotrypsin, and carboxypeptidase are absent or markedly reduced. In some instances of mucoviscidosis one may obtain a partial or selective reduction of enzyme activity.1 In idiopathic celiac disease, as in a great variety of other nutritional disorders, the activity of pancreatic enzymes in duodenal fluid is normal.* However, deficiencies of pancreatic amylase in celiac disease3 and of all the digestive enzymes in some patients with severe malnutrition and in kwashiorkor4 have been claimed. Although alkaline phosphatase is not a "digestive" enzyme, it is also secreted by the pancreas. Its activity in the duodenal contents represents, in addition, the contribution from the liver and of the intestinal mucosa. The purpose of this report
LEUBNER H, SHWACHMAN H. Studies of Duodenal Fluid in: Alkaline Phosphatase. AMA Am J Dis Child. 1955;89(3):341–345. doi:10.1001/archpedi.1955.02050110407012
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