Evaluation and comparison of cathodic trypsin-like immunoreactivity, pancreatic lipase and pancreatic isoamylase in the diagnosis of acute pancreatitis in 849 consecutive patients with acute abdominal pain

1986 ◽  
Vol 157 (2) ◽  
pp. 151-165 ◽  
Author(s):  
Jens Møller-Petersen ◽  
Michael Klærke ◽  
Francesco Dati
1985 ◽  
Vol 31 (7) ◽  
pp. 1207-1210 ◽  
Author(s):  
J Møller-Petersen ◽  
M Klaerke ◽  
F Dati ◽  
T Toth

Abstract In 417 patients (213 men, 204 women) consecutively hospitalized with acute abdominal pain we evaluated the clinical usefulness of a latex-agglutination test at admission to screen for concentrations of pancreatic lipase (EC 3.1.1.3) in serum greater than 300 micrograms/L. The diagnoses of acute pancreatitis (in 25 patients, 6%) and other diseases were made without knowledge of the results of the latex test or of quantification of pancreatic lipase in the serum by enzyme immunoassay. In the latex assay, when agglutination was taken as a positive test for acute pancreatitis, we found a diagnostic efficiency of 0.986 (95% confidence limits: 0.971-0.997) for acute pancreatitis. The predictive value of a positive latex test result with respect to acute pancreatitis was 0.807 (0.625-0.926); the predictive value of a negative test was 1.000 (0.991-1.000). Six patients had false-positive test results. No false-negative test results were found by enzyme immunoassay. We conclude that the latex agglutination test is useful as an emergency test for diagnosis of acute pancreatitis in patients with acute abdominal pain; negative results virtually exclude acute pancreatitis.


1993 ◽  
Vol 27 (1) ◽  
pp. 36-37 ◽  
Author(s):  
Anthony E. Zimmermann ◽  
Brian G. Katona ◽  
Joginder S. Jodhka ◽  
Richard B. Williams

OBJECTIVE: To report a case of probable ceftriaxone-induced acute pancreatitis. CASE SUMMARY: A patient with a history of short-bowel syndrome on home total parenteral nutrition developed fever, chills, and right flank pain. She was diagnosed with gram-negative catheter sepsis and prescribed antibiotic therapy to be administered for four weeks. After completion of the first week of therapy, the antibiotic regimen was changed to intravenous injections of ceftriaxone to be given daily at home. Prior to discharge the patient developed acute abdominal pain, leukocytosis, jaundice, and markedly elevated lipase and amylase concentrations consistent with acute pancreatitis. The patient's condition improved upon discontinuation of the ceftriaxone and the remainder of her stay was uneventful. DISCUSSION: There is only one other case report in the literature of probable ceftriaxone-induced pancreatitis. Multiple other medications have been implicated in causing acute pancreatitis. The exact mechanism of this uncommon adverse effect of ceftriaxone is unknown. CONCLUSIONS: There was a temporal relationship between the development of this patient's signs and symptoms and the administration of ceftriaxone. We could not identify any other factors that may have been responsible for the development of her acute pancreatitis. Ceftriaxone should be considered as a possible etiologic agent in patients who present with acute abdominal pain and elevated lipase and amylase concentrations.


1995 ◽  
Vol 41 (8) ◽  
pp. 1129-1134 ◽  
Author(s):  
P Clavé ◽  
S Guillaumes ◽  
I Blanco ◽  
N Nabau ◽  
J Mercé ◽  
...  

Abstract To determine the utility of serum amylase (AMY), lipase (Lp), pancreatic isoamylase (isoA), phospholipase A (PLA), and urine AMY in the diagnosis of acute pancreatitis, samples of serum and urine were obtained on admission and every day thereafter for 5 days from 384 patients with acute abdominal pain. Diagnostic accuracy, determined as the area under the receiver operating characteristic curve, was > 0.975 for serum AMY, Lp, isoA, and urine AMY. For each of these enzymes, a threshold value (twice to sixfold the upper limit of the reference values) offering diagnostic efficiency > 95% could be determined. In contrast, accuracy and efficiency of serum PLA were low. The profiles of these enzymes in acute pancreatitis decreased in a parallel fashion over 5 days except for PLA. We conclude that diagnostic utilities are similar for serum AMY, Lp, isoA, and urine AMY for acute pancreatitis, provided that an appropriate threshold is established.


JPGN Reports ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. e011
Author(s):  
Raul E. Sanchez ◽  
Colleen B. Flahive ◽  
Ethan A. Mezoff ◽  
Cheryl Gariepy ◽  
W. Garrett Hunt ◽  
...  

Author(s):  
Ko Takamatsu ◽  
Yasuyoshi Kusanagi ◽  
Hideyuki Horikoshi ◽  
Takashi Nakanishi ◽  
Akinori Wada ◽  
...  

Abstract A 78-year-old man presented to our hospital with a history of 10kg weight loss within 6 months previously, and general fatigue and fever for 2 and 1 months, respectively. On hospitalization, the patient was diagnosed with polyarteritis nodosa after multiple microaneurysms were observed in the liver, kidney, pancreas, and mesenteries. He achieved remission with the administration of 1,000mg methylprednisolone for 3 days, followed by prednisolone (55mg/day). Steroids were successfully tapered with no re-elevation in inflammation. Two months after the administration of steroids, the patient complained of acute abdominal pain, and developed severe acute pancreatitis. During treatment for pancreatitis, the patient died due to septic shock and disseminated intravascular coagulation. An autopsy revealed necrotizing vasculitis in the intrapancreatic arteries and ischemia of the downstream arterioles resulting in acute pancreatitis.


2009 ◽  
Vol 91 (5) ◽  
pp. 381-384 ◽  
Author(s):  
Paul A Sutton ◽  
David J Humes ◽  
Gemma Purcell ◽  
Janette K Smith ◽  
Frances Whiting ◽  
...  

INTRODUCTION We aimed to evaluate the role of routine measurements of serum amylase and lipase in the diagnosis of acute abdominal pain. PATIENTS AND METHODS We identified all patients who had serum amylase and lipase assays over a 62-day period at a single university teaching hospital and reviewed their case notes. RESULTS We excluded 58 of the 1598 patients on grounds of ineligibility (< 18 years of age and those transferred from other hospitals). A complete data set was obtained for 1520 (98.7%) of the remaining 1540 patients. Only 9.1% of requests were based on a clinical suspicion of acute pancreatitis. Of the 44 (2.9%) patients who had acute pancreatitis, only 28 (63.6%) had an associated rise in serum amylase and/or lipase 3 times above the maximum reference range, the remainder being diagnosed radiologically. At this cut-off range, the sensitivity and specificity for serum amylase were 50% and 99%, and those for serum lipase 64% and 97%, respectively. CONCLUSIONS Routine measurements of serum amylase and lipase are unhelpful in the diagnosis of acute abdominal pain unless there is clinical suspicion of acute pancreatitis. In these patients, assay of lipase alone is preferable to assay of amylase alone or both enzymes.


2020 ◽  
Vol 50 (2) ◽  
Author(s):  
Soraya López López ◽  
Carlos Marra-López Valenciano ◽  
Federico Bolado Concejo

Mumps are a preventable disease by vaccination, caused by a Paramyxovirus. Even though we are in the vaccination era, different phenomena as the migratory movements, are generating a new rebound of this highly transmissible viral infection. We present a female with a severe epigastric abdominal pain and elevation of alpha-amylase and triacylglycerol lipase in blood analysis, after 48 hours of mumps infection. After the exclusion of more frequent causes, the patient was diagnosed with acute pancreatitis related to mumps. This case shows that, despite it is a rare cause, acute pancreatitis should be considered in patients with mumps who present acute abdominal pain. An early diagnosis and an appropriate treatment are necessary to prevent and minimise morbi-mortality related to acute pancreatitis.


2014 ◽  
Vol 52 (196) ◽  
pp. 982-985 ◽  
Author(s):  
Roshan Ghimire ◽  
Anurag Singh Thapa ◽  
Dimindra Karki ◽  
Dipendra Kumar Shrestha

Introduction: Acute abdominal pain is a common condition presenting to both the emergency department and surgical admission unit. Increase in serum amylase levels are found in much gastrointestinal pathology. Serum amylase level is consistently high in acute pancreatitis though high values are not pathognomonic of pancreatitis .The aim of this study to assess the level of serum amylase in various diseases presenting with acute abdominal pain and to evaluate the role of routine measurement of serum amylase in the screening of patient with acute abdominal pain for the diagnosis of acute pancreatitis in a prospective series. Methods: A prospective observational study was performed from 15th May 2014 – 15th Nov 2014 (6 months) at Department of Surgery of Kathmandu medical College Teaching Hospital; Kathmandu. All consecutive patients presented at emergency department and required admissions in surgical ward were included. A multivariate analysis was performed to assess the level of serum amylase in various diseases presenting with acute abdominal pain including acute pancreatitis. Results: Overall, 318 patients were included during a period of 6 months among them 48 patients were excluded. 34 cases (12.6 %) were diagnosed of acute pancreatitis. three cases (1.1%) of non pancreatic pathology with raised serum amylase level (> 1000 U\L). Conclusions: Routine assessment of serum amylase is helpful in excluding differential diagnosis of patient presenting with acute abdomen and this study identified serum amylase as a good screening tool if done in cases with clinical suspicion.  Keywords: acute abdominal pain; acute pancreatitis; serum amylase.


2018 ◽  
Vol 6 (1) ◽  
pp. 252
Author(s):  
Jagmohan Mishra ◽  
Biplab Mishra ◽  
Afroza Firodous

Background: Acute pancreatitis possess difficulty in diagnosis in its emergency presentation. Hence to segregate this disease is important from other specific or non-specific causes of acute abdomen. Hence in suspected cases in majority of patients the urinary trypsinogen-2 test strip (Actim pancreatitis) can be used to detect this disease, especially in emergency set-up. The result of the strip test is then corroborated with findings of serum lipase in the blood.Methods: Author prospectively compared 205 consecutive patients with acute abdominal pain admitted to the casualty, SCB Medical College and Hospital. The patients were tested on admission with the Actim pancreatitis test strip. Serum amylase, serum lipase, and urine trypsinogen-2 concentrations were also determined quantitatively.Results: The Actim pancreatitis test strip was sensitive in 93% cases and specific in 92% cases. This was superior to that of serum lipase (sensitivity 77% and specificity 87%). With a cut-off >3x the upper reference limit, the sensitivity of serum lipase was only 52% while the specificity was 98%. The high sensitivity for the Actim pancreatitis test strip resulted in every high negative predictive value of 99%.Conclusions: In patients with acute abdominal pain seen in emergency department, a negative dipstick for urinary trypsinogen-2 rules out acute pancreatitis with high degree of probability and therefore appears to be more suitable for screening of acute pancreatitis. With its high specificity with a cut-off >3x the upper reference limit, serum lipase is suitable as a confirmatory test for pancreatitis when a positive dipstick result is obtained.


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