Amylase, lipase, pancreatic isoamylase, and phospholipase A in diagnosis of acute pancreatitis

1995 ◽  
Vol 41 (8) ◽  
pp. 1129-1134 ◽  
Author(s):  
P Clavé ◽  
S Guillaumes ◽  
I Blanco ◽  
N Nabau ◽  
J Mercé ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Operating Characteristic ◽  
Serum Amylase ◽  
Acute Abdominal Pain ◽  
Characteristic Curve ◽  
Threshold Value ◽  
Phospholipase A ◽  
Diagnostic Efficiency ◽  
Pancreatic Isoamylase ◽  
Parallel Fashion

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.

Diagnostic and prognostic utility of phospholipase A activity in patients with acute pancreatitis: comparison with amylase and lipase

1991 ◽  
Vol 37 (3) ◽  
pp. 356-360 ◽  
Author(s):  
Steven C Kazmierczak ◽  
Frederick Van Lente ◽  
Edna D Hodges
Keyword(s):  
Acute Pancreatitis ◽  
Diagnostic Accuracy ◽  
Enzyme Activities ◽  
Serum Amylase ◽  
Characteristic Curve ◽  
Receiver Operator Characteristic Curve ◽  
Curve Analysis ◽  
Phospholipase A ◽  
Cutoff Values ◽  
Prognostic Utility

Abstract We compared the diagnostic and prognostic utility of phospholipase A (PLA; EC 3.1.1.4) for acute pancreatitis with that of amylase and lipase by analysis of sera from 151 consecutive patients presenting with abdominal pain in whom assays of serum amylase and (or) lipase had been ordered. We determined the diagnostic accuracy for both the initial and the peak enzyme activities. Maximal diagnostic accuracy obtained for the initial activities of amylase, lipase, and PLA was 0.83, 0.83, and 0.76 at cutoff values of 650, 650, and 41 U/L, respectively. Use of peak enzyme activities showed maximal diagnostic accuracy of 0.85, 0.86, and 0.73 at cutoff values of 650, 1050, and 42 U/L, respectively. Receiver-operator characteristic curve analysis revealed the diagnostic performance of amylase and lipase to be similar, whereas that of PLA was almost random and not incremental. As with amylase and lipase, PLA activities in sera showed no relation to patients' survival; three patients who died after an attack of acute pancreatitis failed to demonstrate the dramatic increases in PLA activity previously described. We conclude that assessing the severity of acute pancreatitis by using enzyme activities still remains problematical. Measurements of amylase or lipase activities provide similar diagnostic discrimination when appropriate cutoff values are used and remain the methods of choice for diagnosis of acute pancreatitis.

Efficiency in the diagnosis of acute pancreatitis increased by improved electrophoresis of amylase isoenzyme P3 on cellulose acetate.

1985 ◽  
Vol 31 (1) ◽  
pp. 70-75 ◽  
Author(s):  
T H Massey
Keyword(s):  
Acute Pancreatitis ◽  
Complete Resolution ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
True Positive Rate ◽  
Diagnostic Efficiency ◽  
Electrophoretic Method ◽  
Diagnostic Potential ◽  
Positive Rate ◽  
Positive Results

Abstract Serum from patients who have suffered acute pancreatitis contains P3, an isoenzyme of pancreatic-derived amylase (EC 3.2.1.1). Heretofore, complete resolution of P3 from the major salivary isoenzyme in serum, S1, has not been possible, thus compromising the diagnostic potential of P3 for pancreatitis. I describe an electrophoretic method for the essentially complete resolution of P3 from S1 by including CaCl2, 1 mmol/L, in the Tris barbiturate electrophoresis buffer (25 mmol/L, pH 8.8). I evaluated the clinical utility of the method for 129 consecutive patients suspected of having pancreatitis, by using receiver operating characteristic curve analysis for results for total amylase, P2, and P3 activity. For a true-positive rate of 90% with a prevalence of pancreatitis of 7.8%, the diagnostic efficiency was increased from 82% (total amylase) to 91% (P2) to 98% (P3). Thus, including P3 activity in the diagnostic criteria will eliminate most false-positive results for pancreatitis based on total amylase activity alone, and should decrease the need for expensive radiologic procedures currently required to confirm the presence of pancreatitis. I conclude that P3 can be of significant value in the differential diagnosis of pancreatitis from other syndromes with hyperamylasemia.

scholarly journals Are sniffer dogs a reliable approach for diagnosing SARS-CoV-2 infection?

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Giuseppe Lippi ◽  
Camilla Mattiuzzi ◽  
Brandon M. Henry
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Pooled Analysis ◽  
Diagnostic Efficiency ◽  
Diagnostic Specificity ◽  
Summary Receiver Operating Characteristic ◽  
Electronic Search ◽  
Individual Variations ◽  
Infected Material

Abstract Objectives Despite inter-individual variations in their diagnostic efficiency, dogs have been trained to investigate many human pathologies, especially cancer, diabetes, migraine, seizures and even infectious diseases. To this end, we performed a critical review and pooled analysis of current scientific literature on the performance of dogs trained for identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive human specimens. Methods We carried out an electronic search in PubMed, Scopus and Web of Science with the keywords “dog(s)” AND “sniffer” OR “scent” OR “smell” AND “SARS-CoV-2” OR “severe acute respiratory syndrome coronavirus 2” OR “coronavirus disease 2019” OR “COVID-19” within all fields, without date or language restrictions, to identify studies describing dogs’ performance for identifying SARS-CoV-2 infected material. Results Three studies could be finally included in pooled analysis, totaling 17 dogs (47% females), aged between 0.5 and 12 years. The pooled diagnostic sensitivity was 0.88 (95% CI, 0.84–0.91; I 2, 85.3%), the diagnostic specificity 0.99 (95% CI, 0.99–0.99; I 2, 97.4%), whilst the area under the summary receiver operating characteristic curve (SROC) was 0.979 (standard error, 0.003). Conclusions The notable performance observed in this pooled analysis would persuade us to suggest that adequately trained dogs could represent an intriguing and sustainable resource for purposes of rapid SARS-CoV-2 mass screening.

scholarly journals Acute Pancreatitis with Rapid Clinical Improvement in a Child with Isovaleric Acidemia

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Elpis Mantadakis ◽  
Ioannis Chrysafis ◽  
Emmanouela Tsouvala ◽  
Athanassios Evangeliou ◽  
Athanassios Chatzimichael
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Acute Abdominal Pain ◽  
Elevated Serum ◽  
Unknown Origin ◽  
Organic Acidemia ◽  
Abdominal Ultrasonography ◽  
Isovaleric Acidemia ◽  
Intravenous Hydration ◽  
Branched Chain

Isovaleric acidemia is a rare branched-chain organic acidemia. The authors describe a 3.5-year-old girl with isovaleric acidemia and acute abdominal pain associated with bilious emesis. Elevated serum amylase and abdominal ultrasonography demonstrating an enlarged and edematous pancreas, along with the presence of peripancreatic exudates, confirmed the presence of acute pancreatitis. The patient recovered quickly with intravenous hydration, pancreatic rest, and administration of intravenous L-carnitine. Pancreatitis should be ruled out in the context of vomiting in any patient with isovaleric acidemia. Conversely, branched-chain organic acidemias should be included in the differential diagnosis of any child with pancreatitis of unknown origin.

The Utility of Pleural Fluid Lactate Dehydrogenase to Adenosine Deaminase Ratio in Pleural Tuberculosis

Respiration ◽  
2020 ◽  
pp. 1-5
Author(s):  
Amanda Beukes ◽  
Jane Alexandra Shaw ◽  
Andreas H. Diacon ◽  
Elvis M. Irusen ◽  
Coenraad F.N. Koegelenberg
Keyword(s):  
Lactate Dehydrogenase ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Operating Characteristic ◽  
Retrospective Studies ◽  
Characteristic Curve ◽  
Diagnostic Efficiency ◽  
Pleural Tuberculosis ◽  
High Incidence ◽  
The Mean

In high-burden settings, the diagnosis of pleural tuberculosis (TB) is frequently inferred in patients who present with lymphocyte predominant exudative effusions and high adenosine deaminase (ADA) levels. Two recent small retrospective studies suggested that the lactate dehydrogenase (LDH)/ADA ratio is significantly lower in TB than in non-TB pleural effusions and that the LDH/ADA ratio may be useful in differentiating pleural TB from other pleural exudates. We compared the pleural LDH/ADA ratios, ADA levels, and lymphocyte predominance of a prospectively collected cohort of patients with proven pleural TB (<i>n</i> = 160) to those with a definitive alternative diagnosis (<i>n</i> = 68). The mean pleural fluid LDH/ADA ratio was lower in patients with pleural TB than alternative diagnoses (6.2 vs. 34.3, <i>p</i> &#x3c; 0.001). The area under the receiver operating characteristic curve was 0.92 (<i>p</i> &#x3c; 0.001) for LDH/ADA ratio and 0.88 (<i>p</i> &#x3c; 0.001) for an ADA ≥40 U/L alone. A ratio of ≤12.5 had the best overall diagnostic efficiency, while a ratio of ≤10 had a specificity of 90% and a positive predictive value of 95%, with a sensitivity of 78%, making it a clinically useful “rule in” value for pleural TB in high incidence settings. When comparing the LDH/ADA ratio to an ADA level ≥40 U/L in the presence of a lymphocyte predominant effusion, the latter performed better. When lymphocyte values are unavailable, our data suggest that the LDH/ADA ratio is valuable in distinguishing TB effusions from other pleural exudates.

scholarly journals Triglyceride to HDL-C Ratio Is Associated with Plasma D-Dimer Levels in Different Types of Pancreatitis: A Retrospective Single-Centered Study in China

2022 ◽  
Author(s):  
Xiaoqing Jia ◽  
Xiaoting Zhang ◽  
Dalong Sun ◽  
Rong Li ◽  
Na Yang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Control Group ◽  
Recurrent Acute Pancreatitis ◽  
Significant Difference ◽  
Different Types ◽  
Coefficient Corrélation ◽  
The Relationship ◽  
D Dimer

Abstract BackgroundThis study aims to evaluate the relationship between D-dimer and dyslipidemia, especially triglyceride to HDL-C ratio (TG/HDL-C) in different types of pancreatitis. We analyzed the D-dimer and dyslipidemia levels in acute pancreatitis (AP), recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP). Material and MethodsA single-centered retrospective study was conducted on 1013 patients diagnosed with AP, RAP or CP. Only patients hospitalized within 24 h of onset were included, and 204 patients were enrolled in pancreatitis groups. 68 normal persons without pancreatitis, malignant diseases, pregnancy, or organ failure, who had health check-ups, were enrolled in the control group. Blood samples were taken within 24h of admission. The epidemiology and etiology were analyzed. D-dimer and dyslipidemia levels were compared between different types of pancreatitis. Furthermore, the area under the receiver-operating characteristic curve (AUC) was used to estimate the validity of the predictor and to define optimal cut-off points for prediction.ResultsWe found that D-dimer and TG/HDL-C ratio could distinguish mild AP (MAP) and non-MAP in AP and RAP patients. The D-dimer level was related to TG/HDL-C ratio and severity of pancreatitis, with the coefficient correlation of 0.379 and 0.427(p<0.01), respectively. TG/HDL-C was related to D-dimer in different types of pancreatitis. Multivariate analysis was conducted in the parameters at admission like alcohol abuse, dyslipidemia and coagulation disturbance in distinguishing AP and RAP groups from the control group, and the parameter like diabetes in RAP and CP groups significantly increased compared with that of the control group. ConclusionsThe value of D-dimer level and TG/HDL-C ratio in predicting the severity of AP and RAP was confirmed but there was no significant difference between CP group and the control group. The D-dimer level was related to dyslipidemia and TG/HDL-C ratio.

scholarly journals Evaluation on the Diagnostic Efficiency of Different Methods in Detecting COVID-19.

2020 ◽  
Author(s):  
Haitao Yang ◽  
Yuzhu Lan ◽  
Xiujuan Yao ◽  
Sheng Lin ◽  
Baosong Xie
Keyword(s):  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
Web Of Science ◽  
Characteristic Curve ◽  
Positive Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Efficiency ◽  
Summary Receiver Operating Characteristic ◽  
Operating Characteristic Curve ◽  
Higher Sensitivity

Abstract Objective: To evaluate the diagnostic efficiency of different methods in detecting COVID-19.Methods: PubMed, Web of Science and Embase databases were searched for identifing eligible articles. All data were calculated utilizing Meta Disc 1.4, Revman 5.3.2 and Stata 12. The diagnostic efficiency was assessed via these indicators including summary sensitivity and specificity, positive likelihood ratio (PLR), negative LR (NLR), diagnostic odds ratio (DOR), summary receiver operating characteristic curve (sROC) and calculate the AUC. Results: 18 articles (3648 cases) were included. EPlex: pooled sensitivity was 0.94; specificity 1.0; PLR 90.91; NLR 0.07; DOR 1409.49; AUC=0.9979, Q*=0.9840. Panther Fusion: pooled sensitivity was 0.99; specificity 0.98; PLR 42.46; NLR 0.02; DOR 2300.38; AUC=0.9970, Q*=0.9799. Simplexa: pooled sensitivity was 1.0; specificity 0.97; PLR 26.67; NLR 0.01; DOR 3100.93; AUC=0.9970, Q*=0.9800. Cobas®: pooled sensitivity was 0.99; specificity 0.96; PLR 37.82; NLR 0.02; DOR 3754.05; AUC=0.9973, Q*=0.9810. RT-LAMP: pooled sensitivity was 0.98; specificity 0.99; PLR 36.22; NLR 0.04; DOR 751.24; AUC=0.9905, Q*=0.9596. Xpert Xpress: pooled sensitivity was 0.99; specificity 0.97; PLR 27.44; NLR 0.01; DOR 3488.15; AUC=0.9977, Q*=0.9829.Conclusions: These methods (ePlex, Panther Fusion, Simplexa, Cobas®, RT-LAMP and Xpert Xpress) bear higher sensitivity and specificity, and might be efficient methods complement to the gold standard.

scholarly journals The relationship between serum triglyceride levels and acute pancreatitis in an animal model and a 14-year retrospective clinical study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Qiyue Zhang ◽  
Mengbin Qin ◽  
Zhihai Liang ◽  
Huali Huang ◽  
Yongfeng Tang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Study ◽  
Operating Characteristic ◽  
Serum Amylase ◽  
Animal Experiments ◽  
Serum Triglyceride ◽  
Pancreatic Injury ◽  
Roc Curve Analysis ◽  
Retrospective Clinical Study ◽  
The Relationship

Abstract Objectives The aim of the current study was to evaluate influence of serum triglyceride levels on the course of acute pancreatitis (AP). Methods Rats models of hypertriglyceridemic were used in animal experiments. Following induction of acute pancreatitis, amylase, and pancreas histological scores were all compared. In addition, in a clinical study, clinical data were collected from 1681 AP patients admitted from 2003 to 2016 who were divided into 4 groups based on their serum triglyceride (TG) levels. The clinical features among these 4 groups were compared, and a receiver operating characteristic (ROC) curve analysis was also performed on TG values to estimate their relationship with severity. Results In animal experiments, the hypertriglyceridemic pancreatitis (HTGP) group had markedly higher serum amylase, and histological scores relative to the other animal groups. In the clinical study, we identified significant differences in gender, age, body mass index (BMI), cost, and incidence of partial complications among the 4 TG-based groups. Importantly, the TG levels on day 3–4 after admission could be used to accurately predict disease severity. Conclusions Hypertriglyceridemia (HTG) can aggravate pancreatic injury, and hypertriglyceridemia patients are more likely to suffer from severe pancreatic injury with a higher possibility of complications. In addition, triglyceride levels are correlated with the severity of AP positively.

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