Diagnostic value of immunoreactive phospholipase A2 in acute pancreatitis

Abstract Immunoreactive phospholipase A2 (EC 3.1.1.4) was measured by a new sensitive time-resolved fluoroimmunoassay in the serum of 58 healthy subjects and 103 patients with acute pancreatitis. Patients with acute pancreatitis were grouped according to the etiology and clinical severity of the disease. The mean phospholipase A2 concentration in the reference (healthy) group was 5.5 (SD 1.9) micrograms/L. In acute pancreatitis the mean phospholipase A2 concentration was increased on the first day after hospital admission in all groups, and returned to normal somewhat more slowly than did serum amylase, especially in the patients with severe alcoholic pancreatitis. In this latter group the mean concentration of serum phospholipase A2 on the first day was 42.6 (SD 29.5) micrograms/L. In patients with pancreatic cancer, serum phospholipase A2 was 29.2 (SD 21.3) micrograms/L. The phospholipase A2 and amylase values were closely associated in all groups. The clinical sensitivities were 90.9% for severe alcoholic pancreatitis and 87.5% for pancreatic cancer. Immunochemical determination of phospholipase A2 in serum provides fast and specific detection of injury to pancreatic acinar cells. In addition to the early diagnosis of acute pancreatitis, follow-up determinations of phospholipase A2 seem to be useful in differentiating between mild and severe forms of pancreatitis.

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Serum Phospholipase A2 in Canine Acute Pancreatitis

Acta Veterinaria Scandinavica ◽

10.1186/bf03546719 ◽

1983 ◽

Vol 24 (4) ◽

pp. 477-487

Author(s):

E. Westermarck ◽

E. Rimaila-Pärnänen

Keyword(s):

Acute Pancreatitis ◽

Phospholipase A2

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Kinetics of Group IB and IIA Phospholipase A2 During Low-Volume Continuous Hemodiafiltration in Severe Acute Pancreatitis

Artificial Organs ◽

10.1111/j.1525-1594.2007.00398.x ◽

2007 ◽

Vol 31 (5) ◽

pp. 395-401 ◽

Cited By ~ 5

Author(s):

Masaharu Suzuki ◽

Toshiya Okahisa ◽

Masahiro Sogabe ◽

Hiroshi Iwaki ◽

Yoshio Okita ◽

...

Keyword(s):

Acute Pancreatitis ◽

Phospholipase A2 ◽

Severe Acute Pancreatitis ◽

Continuous Hemodiafiltration ◽

Low Volume ◽

Kinetics Of

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Bactericidal/Permeability-Increasing Protein and Group I and II Phospholipase A2 During the Induction Phase of Human Acute Pancreatitis

Pancreas ◽

10.1097/00006676-199901000-00003 ◽

1999 ◽

Vol 18 (1) ◽

pp. 21-27 ◽

Cited By ~ 8

Author(s):

E. Kemppainen ◽

A. Hietaranta ◽

P. Puolakkainen ◽

V. Sainio ◽

J. Halttunen ◽

...

Keyword(s):

Acute Pancreatitis ◽

Phospholipase A2 ◽

Induction Phase ◽

Group I ◽

Human Acute Pancreatitis

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Phospholipase A2 in Acute Pancreatitis

Acute Pancreatitis ◽

10.1007/978-3-642-83027-3_11 ◽

1987 ◽

pp. 71-78 ◽

Cited By ~ 6

Author(s):

T. J. Nevalainen ◽

H. J. Aho

Keyword(s):

Acute Pancreatitis ◽

Phospholipase A2

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Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choice

Journal of Innovation in Health Informatics ◽

10.14236/jhi.v24i3.907 ◽

2017 ◽

Vol 24 (3) ◽

pp. 257 ◽

Cited By ~ 3

Author(s):

Cassie Jaeger ◽

Paul Sullivan ◽

James Waymack ◽

David Griffen Griffen

Keyword(s):

Emergency Department ◽

Acute Pancreatitis ◽

Abdominal Pain ◽

Diagnostic Testing ◽

Value Added ◽

Diagnostic Value ◽

Order Entry ◽

Computerized Provider Order Entry ◽

Quality Patient Care ◽

One Year

Background Amylase and lipase, pancreatic biomarkers, are measured in acute pancreatitis diagnosis. Since amylase testing does not add diagnostic value, lipase testing alone is recommended. Despite new recommendations, many physicians and staff continue to test both amylase and lipase.Objective To reduce unnecessary diagnostic testing in acute pancreatitis.Methods The pre-checked amylase test within the Emergency Department’s Computerized Provider Order Entry (CPOE) abdominal pain order set was changed to an un-checked state, but kept as an option to order with a single click. Amylase testing, lipase testing and cost were measured for one year pre and post intervention.Results Simple de-selection intervention reduced redundant amylase testing from 71% to 9%, resulting in a percent of decrease of 87% and an annualized saving of approximately $719,000 in charges.Conclusion CPOE de-selection is an effective tool to reduce non-value added activity and reduce cost while maintaining quality patient care and physician choice.

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Polyclonal pancreatic elastase assay is superior to monoclonal assay for diagnosis of acute pancreatitis

Clinical Chemistry ◽

10.1093/clinchem/43.12.2339 ◽

1997 ◽

Vol 43 (12) ◽

pp. 2339-2344 ◽

Cited By ~ 5

Author(s):

Volker Keim ◽

Niels Teich ◽

Andrea Reich ◽

Fritz Fiedler ◽

Joachim Mössner

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Polyclonal Antibodies ◽

Roc Curves ◽

Diagnostic Value ◽

Serum Concentrations ◽

Clinical Value ◽

Serum Samples ◽

Pancreatic Elastase ◽

Serum Elisa

Abstract We compared the clinical values for diagnosis of acute pancreatitis of two commercial assays for pancreatic elastase: an ELISA procedure with monoclonal antibodies and a RIA technique with polyclonal antibodies. In 14 patients with acute pancreatitis, serum concentrations of elastase determined by ELISA (ELISA-elastase) decreased much faster (half-life 0.4 days) than those of elastase determined by RIA (RIA-elastase) (2.2 days), amylase (0.8 days), or lipase (0.9 days). Serum samples from 253 additional patients with abdominal pain (32 of these with acute pancreatitis) were analyzed. In sera collected up to 48 h after the onset of disease, the ROC curves showed a slightly higher diagnostic value of RIA-elastase. In samples taken later, at a sensitivity of 90% the specificity of RIA-elastase was 95% (ELISA-elastase 40%). We conclude that serum ELISA-elastase is of much lower clinical value than RIA-elastase for diagnosis of acute pancreatitis.

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