scholarly journals Urine trypsinogen-2 as marker of acute pancreatitis

1996 ◽  
Vol 42 (5) ◽  
pp. 685-690 ◽  
Author(s):  
J Hedström ◽  
V Sainio ◽  
E Kemppainen ◽  
P Puolakkainen ◽  
R Haapiainen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Serum Amylase ◽  
Time Resolved ◽  
Abdominal Disease ◽  
Serum Trypsinogen ◽  
Urine Amylase ◽  
Better Than

Abstract We examined the clinical utility of urine trypsinogen-2 as a marker of acute pancreatitis (AP). Fifty-nine patients with AP, 42 with acute abdominal diseases of extrapancreatic origin, and 63 without evidence of acute abdominal disease were studied. Urine trypsinogen-2 was determined by a time-resolved immunofluorometric assay. As reference methods we used serum trypsinogen-2, urine amylase, and serum amylase. The diagnostic accuracy of the markers was evaluated by receiver-operating characteristic (ROC) analysis. At admission, urine trypsinogen-2 differentiated patients with AP from controls with high accuracy. The area under the ROC curve (AUC) was 0.978, which was equal to that of serum trypsinogen-2 (0.998) and serum amylase (0.969) and significantly larger than that of urine amylase. For differentiation between severe and mild AP, urine trypsinogen-2 (0.730) was equal to serum trypsinogen-2 (0.721), and clearly better than amylase in serum and urine. These results suggest that determination of urine trypsinogen-2 is a useful test to detect AP and to evaluate disease severity.

Factitiously Low Amylase Values

1963 ◽  
Vol 9 (3) ◽  
pp. 296-311 ◽  
Author(s):  
Sylvan M Sax ◽  
George E Trimble
Keyword(s):  
Acute Pancreatitis ◽  
Reducing Sugars ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Good Precision ◽  
Urine Amylase ◽  
Serum And Urine

Abstract When a commercial substrate was used in the determination of serum amylase activities of patients with acute pancreatitis, results much higher than those reported by the manufacturer with similar patients were found. A failure to quantitate all of the reducing groups liberated during incubation may account for the lower results. A modified saccharogenic method has been developed, which, by increasing the ratios of starch to enzyme and copper to reducing sugars, considerably extends the range of the determination. Unequivocally elevated serum and urine amylase values can be measured without repetition of all or part of the test and with good precision.

scholarly journals Secrets, puzzles and mysteries of macroamylasemia

2020 ◽  
Vol 46 (1) ◽  
pp. 12-22
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
G. M. Lukashevich ◽  
T. L. Mozhyna
Keyword(s):  
Serum Amylase ◽  
Amylase Activity ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Normal Serum ◽  
Amylase Level ◽  
Clearance Ratio ◽  
Urine Amylase ◽  
Classical Constant

Physiological features of amylase synthesis and excretion are considered in the article, presence of other sources of amylase synthesis different from pancreas and salivary glands is emphasized. Definitions of hyperenzymemia and macroamylasemia (MAE) are given. MAE is a state characterized by presence of circulating complexes of normal serum amylase with protein or carbohydrates in blood. There are 3 types of MAE: first — classical (constant hyperamylasemia, decreased amylase level in urine, high blood concentration of macroamylase complexes); second — hyperamylasemia with slightly decreased amylase activity in urine, macroamylase/normal amylase ratio is less than in the first type; third — normal blood and urine amylase activity, low macroamylase/normal amylase ratio. Pathogenesis is explained by connection of blood amylase and acute phase protein in different inflammatory, infectious diseases, malabsorption. MAE clinical manifestations could be absent, sometimes abdominal pain is possible. Hyperamylasemia and reduced urine amylase activity are typical. MAE diagnostics means determination of macroamylase complexes in blood (chromatography, calculation of the clearance ratio of amylase and creatinine). The article presents clinical cases describing extra-pancreatic MAE in women with malignant ovarian lesions. The question of expediency of thorough diagnostic examination in asymptomatic MAE is raised, which may turn out to be a symptom of cancer. The lack of specific treatment for MAE is emphasized.

Combined serum amylase and lipase determinations for diagnosis of suspected acute pancreatitis

1993 ◽  
Vol 39 (12) ◽  
pp. 2495-2499 ◽  
Author(s):  
J P Corsetti ◽  
C Cox ◽  
T J Schulz ◽  
D A Arvan
Keyword(s):  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Test Performance ◽  
Serum Amylase ◽  
Discriminant Functions ◽  
Clinical Implementation ◽  
Sensitivity Specificity ◽  
Bivariate Approach

Abstract Serum amylase and lipase measurements are often used to diagnose acute pancreatitis. This study addresses the question of whether it is advantageous to order serum amylase and lipase tests simultaneously. We evaluated performance of the two tests separately and in combination through a retrospective study of patients for whom both amylase and lipase determinations were ordered. Initial analysis of test performance was conducted with a uniformly applied criterion based on determination of optimal sensitivity-specificity pairs. Individual tests and combinations of tests, including the "AND" and "OR" rules and discriminant functions, were examined. Only the discriminant approach demonstrated better performance than the lipase test alone. This finding was subsequently confirmed by logistic regression analysis. We conclude that ordering both tests simultaneously can be advantageous in diagnosing acute pancreatitis when a bivariate approach is used; however, this must be weighed against the difficulties associated with clinical implementation of such approaches.

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.

scholarly journals Risk Factors of Acute Pancreatitis in Oral Double Balloon Enteroscopy

2016 ◽  
Vol 59 (3) ◽  
pp. 84-90 ◽  
Author(s):  
Marcela Kopáčová ◽  
Jan Bureš ◽  
Stanislav Rejchrt ◽  
Jaroslava Vávrová ◽  
Jolana Bártová ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Double Balloon Enteroscopy ◽  
Serum Lipase ◽  
Balloon Enteroscopy ◽  
Double Balloon ◽  
Laboratory Markers ◽  
Before And After ◽  
Hs Crp ◽  
Urine Amylase

Double balloon enteroscopy (DBE) was introduced 15 years ago. The complications of diagnostic DBE are rare, acute pancreatitis is most redoubtable one (incidence about 0.3%). Hyperamylasemia after DBE seems to be a rather common condition respectively. The most probable cause seems to be a mechanical straining of the pancreas. We tried to identify patients in a higher risk of acute pancreatitis after DBE. We investigated several laboratory markers before and after DBE (serum cathepsin B, lactoferrin, E-selectin, SPINK 1, procalcitonin, S100 proteins, alfa-1-antitrypsin, hs-CRP, malondialdehyde, serum and urine amylase and serum lipase). Serum amylase and lipase rose significantly with the maximum 4 hours after DBE. Serum cathepsin and procalcitonin decreased significantly 4 hours after DBE compared to healthy controls and patients values before DBE. Either serum amylase or lipase 4 hours after DBE did not correlate with any markers before DBE. There was a trend for an association between the number of push-and-pull cycles and procalcitonin and urine amylase 4 hours after DBE; between procalcitonin and alfa-1-antitrypsin, cathepsin and hs-CRP; and between E-selectin and malondialdehyde 4 hours after DBE. We found no laboratory markers determinative in advance those patients in a higher risk of acute pancreatitis after DBE.

Determination of amylase activity in serum by using a wheat germ inhibitor with the Du Pont aca.

1986 ◽  
Vol 32 (8) ◽  
pp. 1539-1541 ◽  
Author(s):  
D A Lacher ◽  
M B Harize
Keyword(s):  
Acute Pancreatitis ◽  
Wheat Germ ◽  
Serum Amylase ◽  
Amylase Activity ◽  
Reference Interval ◽  
Pancreatic Amylase ◽  
Wheat Germ Extract ◽  
Rapid Procedure ◽  
Assay Conditions

Abstract A rapid procedure for determining salivary- and pancreatic-type amylase (EC 3.2.1.1) in serum by incorporating a wheat germ inhibitor (from Triticum aestivum) was developed for the Du Pont aca IV analyzer. Under optimal assay conditions, activities of salivary and pancreatic amylase were inhibited by 93% and 19%, respectively. The 95% central reference interval for the percentage of inhibition of serum amylase was 38-84%. Patients with acute pancreatitis showed less than 26% inhibition of amylase after addition of the wheat germ extract, reflecting the prevalence of pancreatic-type amylase in this disorder.

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.

scholarly journals The Globulin, A/G and NLR do not Perform better than CRP and ESR in PJI Diagnosis

2021 ◽  
Author(s):  
JingBo Jiao ◽  
Jin-cheng Huang ◽  
Xiao Chen ◽  
Yi Jin
Keyword(s):  
Aseptic Loosening ◽  
Roc Curve ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Demographic Data ◽  
Joint Infection ◽  
Expression Level ◽  
Roc Curve Analysis ◽  
Reactive Protein ◽  
Better Than

Abstract Objective: To test the significance of serum C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), globulin(GLN) , albumin to globulin ratio (A/G), and neutrophil to lymphocyterate (NLR) in periprosthetic joint infection (PJI) diagnosis. Methods: We retrospectively analyzed the clinical data of 115 patients diagnosed from January 2017 to December 2020 with PJI (PJI group, median age 71.00 years [range, 41-94 years], 24 males, 29 females), and aseptic loosening (aseptic group, median age 68.50 years [range, 34–85 years], 32 male, 30 female) in our department. Demographic data and thesensitivity and specificity of preoperative CRP, ESR, GLB,A/G, and NLR in PJI diagnosis were compared. Results: There were no significant differences when the demographic data of the two groups were compared. The expression level of CRP (24.89 mg/L([IQR], 0.1 to 200)), ESR (3 mm/h([IQR], 6 to 120)), GLB (31.70 g/L ( [IQR], 18.50 to 60.60)), and NLR (2.51([IQR], 0.93 to 12.23)) in the PJI group were higher than in the aseptic loosening group (CRP: 2.245 mg/L([IQR], 0.2 to 111.94);ESR: 16 mm/h ([IQR], 2 to 76); GLB: 26.60 g/L([IQR], 17.90 to 68.20); NLR: 1.85([IQR], 0.63 to 9.09)). The expression level of A/G (1.15([IQR], 0.55 to 2.16)) in the PJI group was lower than in the aseptic loosening group (1.51([IQR], 0.71 to 2.40)). Receiver operating characteristic (ROC) curve analysis demonstrated that the areas under the ROC curve (AUC) for CRP, ESR, GLB,A/G, and NLR were 0.841 (95% confidence interval, 0.761-0.903), 0.850 (0.771-0.910),0.747(0.658-0.824),0.779(0.692–0.851), and 0.708 (0.616–0.789), respectively. When GLB > 26.6g/L, A/G ＜1.32, and NLR >2.1 were set as the threshold values for the diagnosis of PJI, The sensitivity of GLB and A/G (90.57%, 81.13%) is higher than CRP (71.70%) and ESR (79.25%), but the specificity (GLB: 51.61%, A/G: 72.58%) was significantly lower than of CRP (87.10%) and ESR (75.81%). The ROC analysis of NLR showed that its sensitivity (73.58%) and specificity (70.97) had no significant advantages over CRP and ESR. Conclusion: globulin, A/G and NLR do not perform better than CRP and ESR in PJI diagnos is.

scholarly journals The Ratio of Trypsin-2-α1-Antitrypsin to Trypsinogen-1 Discriminates Biliary and Alcohol-induced Acute Pancreatitis

2001 ◽  
Vol 47 (2) ◽  
pp. 231-236 ◽  
Author(s):  
Jan M Andersén ◽  
Johan Hedström ◽  
Esko Kemppainen ◽  
Patrik Finne ◽  
Pauli Puolakkainen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Rapid Determination ◽  
Roc Curves ◽  
Curve Analysis ◽  
Central Hospital ◽  
Serum Samples ◽  
Roc Curve Analysis ◽  
Time Resolved ◽  
Appropriate Treatment

Abstract Background: Rapid determination of the etiology of acute pancreatitis (AP) enables institution of appropriate treatment. We evaluated the ability of trypsinogen-1, trypsinogen-2, trypsin-1-α1-antitrypsin (AAT), and trypsin-2-AAT in serum to identify the etiology of AP. Methods: The study consisted of 67 consecutive patients with AP admitted to Helsinki University Central Hospital. Forty-two had alcohol-induced AP, 16 had biliary AP, and 9 had unexplained etiology. Serum samples were drawn within 12 h after admission. Trypsinogen-1, trypsinogen-2, trypsin-1-AAT, and trypsin-2-AAT were determined by time-resolved immunofluorometric assays. Logistic regression was used to estimate the ability of the serum analytes to discriminate between alcohol-induced and biliary AP. The validity of the tests was evaluated by ROC curve analysis. Results: Patients with alcohol-induced AP had higher median values of trypsin-1-AAT (P = 0.065), trypsinogen-2 (P = 0.034), and trypsin-2-AAT (P <0.001) than those with biliary AP, who had higher values of amylase (P = 0.002), lipase (P = 0.012), and alanine aminotransferase (P = 0.036). The ratios of trypsin-2-AAT to trypsinogen-1, lipase, or amylase efficiently discriminated between biliary and alcohol-induced AP (areas under ROC curves, 0.92–0.96). Conclusions: Trypsinogen-2 and trypsin-2-AAT are markedly increased in AP of all etiologies, whereas trypsinogen-1 is increased preferentially in biliary AP. The trypsin-2-AAT/trypsinogen-1 ratio is a promising new marker for discrimination between biliary and alcohol-induced AP.

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