Hyperamylasemia and acute pancreatitis following anticholinesterase poisoning

2007 ◽  
Vol 26 (6) ◽  
pp. 467-471 ◽  
Author(s):  
Surjit Singh ◽  
Udaybhan Bhardwaj ◽  
Suresh k. Verma ◽  
Ashish Bhalla ◽  
Kirandip Gill
Keyword(s):  
Acute Pancreatitis ◽  
Computerized Tomography ◽  
Time Course ◽  
Serum Amylase ◽  
Elevated Serum ◽  
The Other ◽  
Total Serum ◽  
Cholinergic Syndrome ◽  
A Prospective Study ◽  
Elevated Transaminases

A prospective study was undertaken to find the incidence of hyperamylasemia and acute pancreatitis in patients with anticholinesterase poisoning. This was done by serial estimation of total serum amylase and pancreatic imaging by ultrasonography and confirmed, if necessary, by computerized tomography. Anticholinesterase poisoning was caused by either ingestion or accidental exposure to organophosphates or carbamates; it was diagnosed when patients presented with features of cholinergic crisis, depressed serum butrylcholinesterase activity of >50% and showed improvement following administration of atropine alone or atropine and 2-PAM. All the patients admitted with anticholinesterase poisoning between July 2001 and June 2005 were prospectively studied for elevated serum amylase. The serum amylase levels were estimated daily up to 10 days in survivors and in nonsurvivors till they survived. Ultrasonography of the abdomen was carried out in all to find swelling of the pancreas. Computerized tomography was undertaken in those who had a swollen pancreas or whose serum amylase levels were elevated significantly (≥800 S.U). Of the 86 patients enrolled, 79 were taken up for analysis as data were incomplete in 7. Of the 79 patients, serum amylase was found to be elevated that is, >200 S.U. in 37 patients (46.95%). In three patients it was 800 S.U. One of them showed swollen pancreas on ultrasonography, which was confirmed by computerized tomography. This patient had ingested propoxyfur. In the other two patients, evidence of acute pancreatitis was not observed (on autopsy in one who died and on imaging in the other who survived). They had ingested chlorpyriphos. There was no significant correlation between the nature of the compounds (organophosphate or carbamates), inhibition of serum BUChE at admission, duration and severity of cholinergic syndrome and increase and time course of increase in serum amylase. Except for fenthion, significant persistent increase in serum amylase was not observed with individual compounds. The other associated abnormalities were polymorphonuclear leukocytosis (TLC >11 000/cumm) in all 37 patients who had elevated amylase, hyperglycemia (6/37) and, elevated transaminases (6/37). Mild elevation of serum amylase is common in patients with anticholinesterase poisoning. However, acute pancreatitis is rare. Human & Experimental Toxicology (2007) 26, 467—471

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.

scholarly journals Abdominal pain and a raised amylase? It’s not always pancreatitis…

2013 ◽  
Vol 12 (3) ◽  
pp. 163-165
Author(s):  
IO Oluwatowoju ◽  
◽  
EO Abu ◽  
G Lawson ◽  
◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Elevated Serum ◽  
High Serum ◽  
Amylase Level ◽  
Serum Amylase Level ◽  
Heavy Alcohol ◽  
Heavy Alcohol Consumption ◽  
History Of

We report the case of a 72 year old man with a history of COPD and heavy alcohol consumption who was initially diagnosed with acute pancreatitis based on a presentation with epigastric pain and elevated serum amylase. Review of his notes revealed several previous similar admissions and extensive normal investigations apart from persistently elevated amylase. Further analysis showed evidence of macroamylasaemia which accounted for the apparently high serum amylase level.

scholarly journals Does Elevated Serum Levels of Procalcitonin Potentially Correlate with Severity of Acute Pancreatitis: A Prospective Study

2018 ◽  
Vol 08 (02) ◽  
Author(s):  
Irfan A Shera ◽  
Muzafar Rashid Shawl ◽  
Suneel Chakravarty ◽  
Vivek Raj ◽  
Ashwini K Setya
Keyword(s):  
Acute Pancreatitis ◽  
Prospective Study ◽  
Elevated Serum ◽  
Serum Levels ◽  
A Prospective Study

THE EFFECT OF CODEINE ON RAT SERUM AMYLASE

1954 ◽  
Vol 32 (6) ◽  
pp. 625-627
Author(s):  
G. Stuart Wiberg ◽  
Jules Tuba
Keyword(s):  
Gall Bladder ◽  
Adult Male ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Sphincter Of Oddi ◽  
The Other ◽  
Male Rats ◽  
Rat Serum ◽  
Other Hand

Adult male rats did not display an elevated serum amylase following injection of codeine. Mice, on the other hand, showed significantly increased values of the enzyme after treatment with codeine. The significance of these findings are discussed from the standpoint of the tonus of the sphincter of Oddi, and the presence or absence of a gall bladder.

Acute painless pancreatitis as an unusual presentation of leptospirosis in a low-incidence country

2020 ◽  
Vol 13 (8) ◽  
pp. e234988
Author(s):  
Ami Schattner ◽  
Ina Dubin ◽  
Yair Glick ◽  
Elizabeth Nissim
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Liver Enzymes ◽  
Elevated Serum ◽  
Kidney Injury ◽  
C Reactive Protein ◽  
Diagnostic Challenge ◽  
Reactive Protein ◽  
Animal Contact ◽  
Low Incidence

A healthy, urban-dwelling man presented with lassitude, jaundice without increased liver enzymes or obstructive features on imaging, brief acute kidney injury, leucocytosis with near-normal C reactive protein and markedly increased serum amylase and lipase. Leptospirosis was not considered for 10 days because of the low incidence of the disease in the country, absent animal contact and physicians’ low index of suspicion. Presentation without fever and without the commonly associated abdominal pain, myalgia, headache, thrombocytopaenia or elevated serum creatine kinase added to the diagnostic challenge. Once an infectious cause of acute pancreatitis was contemplated, leptospirosis was immediately sought and diagnosed by PCR of urine and microscopic agglutination test, and he fully recovered on ceftriaxone. Physicians in countries with a low incidence of leptospirosis should be more aware of the possibility of the disease even when several key features such as fever or pain are missing and the patient has a rare infectious acute pancreatitis.

A Cause of Misleading Serum Amylase Concentrations in Acute Pancreatitis

1977 ◽  
Vol 22 (2) ◽  
pp. 151-153 ◽  
Author(s):  
L. A. Donaldson ◽  
W. McIntosh
Keyword(s):  
Acute Pancreatitis ◽  
Serum Level ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Serial Dilutions

The operative discovery of acute pancreatitis associated with gross hyperlipidaemia but a normal or high elevated serum amylase concentration has been described. We report a case of acute pancreatitis in which serial dilutions of serum resulted in a 338 per cent rise in the serum amylase concentrations. The importance of appreciating this effect of hyperlipidaemia on the serum level measurements in patients with acute pancreatitis is re-emphasised.

scholarly journals Clinical Profile of Acute Pancreatitis in Children in a Tertiary Level Hospital of Bangladesh

2017 ◽  
Vol 40 (3) ◽  
pp. 160-165
Author(s):  
Nadira Musabbir ◽  
ASM Bazlul Karim ◽  
Md Wahiduzzaman Mazumder ◽  
Kaniz Sultana ◽  
Syeda Afria Anwar ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Serum Amylase ◽  
Abdominal Mass ◽  
Elevated Serum ◽  
Clinical Feature ◽  
Cross Sectional ◽  
Female Ratio ◽  
Epigastric Region ◽  
Common Location

Background: Acute pancreatitis is an acute inflammatory condition of the pancreas that may extend to local and distant extrapancreatic tissues. The incidence of acute pancreatitis in children has increased significantly in the past two decades. It can be associated with severe morbidity and mortality. It should be considered in every child with unexplained acute abdominal pain.Objectives: To observe the clinical, biochemical and imaging profiles of acute pancreatitis in children.Methods: It was a cross-sectional study conducted at the Department of Pediatric Gastroenterology & Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2014 through June 2015. A total of 50 cases of acute pancreatitis were included in this study. The diagnosis of acute pancreatitis was based on diagnostic criteria of acute pancreatitis made by INSPPIRE group (If a child had any 2 of the 3 criteria: the abdominal pain compatible with acute pancreatitis, elevated serum amylase and /or lipase level more than three times of upper limit of normal, imaging findings compatible with acute pancreatitis). Clinical characteristics, laboratory and imaging profile of the cases, complications were studied.Results: Among 50 cases, male were 46% and male female ratio was 0.8:1. Mean age at presentation was 10.2 ± 3.2 years. Forty eight (96%) patients had abdominal pain which was severe agonizing in 81.3% cases. The common location of pain was in epigastric region (77%). Pain radiating to back in 22.9% patients. Mean duration of pain was 6.6 ± 4.4 days before hospital admission. Vomiting was present in 72% patients followed by fever (30%). Two (4%) patients had jaundice. Ascites was noted in 12% patients and abdominal mass in 6% patients. Out of 50 cases of AP, biliary sludge was associated in 6% patients, biliary ascariasis in 4%, choledochal cyst in 2% and gallbladder stone in 2% patients. But in this study, 4% patients had Wilson disease. Laboratory tests showed leukocytosis in 28% patients, high serum amylase and lipase level in 56% and 58% patients respectively. Postive findings in ultrasonogram were present in 66% patients. In the present study, hypocalcemia was found in 38% patients, pseudocyst in 6% and pancreatic necrosis in 2% patients.Conclusion: Although acute pancreatitis may present with varieties of clinical feature, the most common one is abdominal pain and common location of pain is in epigastric region. For confirmation of clinically diagnosed pancreatitis, both serum amylase and lipase level and abdominal ultrasound are useful tools.Bangladesh J Child Health 2016; VOL 40 (3) :160-165

Acute pancreatitis with Kawasaki disease: analysis of cases with elevated serum amylase levels

2004 ◽  
Vol 164 (3) ◽  
pp. 180-181 ◽  
Author(s):  
Takeshi Asano ◽  
Nobuko Sasaki ◽  
Kentaroh Yashiro ◽  
Takayuki Hatori ◽  
Kentaroh Kuwabara ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Kawasaki Disease ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Analysis Of Cases ◽  
Disease Analysis

scholarly journals Prevalence and time course of elevated serum levels of liver enzymes in otherwise healthy Thai infants with breast milk jaundice: a cohort study

2020 ◽  
Vol 14 (2) ◽  
pp. 67-73
Author(s):  
Pirarat Kotcharit ◽  
Voranush Chongsrisawat ◽  
Susheera Chatproedprai
Keyword(s):  
Breast Milk ◽  
Time Course ◽  
Liver Enzymes ◽  
Elevated Serum ◽  
Serum Levels ◽  
Breast Milk Jaundice ◽  
Glutamyl Transferase ◽  
A Prospective Study ◽  
Watchful Waiting Strategy

AbstractBackgroundNeonatal jaundice and elevated levels of liver enzymes are found in infants with breast milk jaundice (BMJ).ObjectivesTo determine the prevalence and duration of elevated serum levels of liver enzymes in Thai infants with BMJ.MethodsWe conducted a prospective study of Thai infants with BMJ, excluding those with pathological causes of jaundice. We measured the serum levels of total bilirubin (TB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and γ-glutamyl transferase (GGT); followed infants with elevated levels; and estimated the time for levels to become normal using Kaplan–Meier analysis.ResultsWe included 42 infants (median age: 17.5 days) with BMJ, and elevated serum levels of at least 1 enzyme were found in 27 (64%) infants. We excluded 4 (10%) infants because they did not continue to be exclusively breastfed, 17 (40%) were lost to follow-up, and 21 (50%) completed the study. We found that 19 (45%) of the 42 infants had elevated GGT, 11 (26%) had elevated ALT, and 9 (21%) each had elevated AST and ALP levels. The median time for enzyme levels to normalize was 291 days (95% confidence interval [CI], 109.8 to 472.2) for ALT, 240 days (95% CI, 139.0 to 340.9) for AST, 184 days (95% CI, 4.4 to 363.6) for ALP, 120 days (95% CI, 74.6 to 164.5) for TB, and 63 days (95% CI, 61.44 to 64.6) for GGT. Infants were otherwise healthy during the follow-up.ConclusionThe prevalence of elevated serum levels of liver enzymes in Thai infants was unexpectedly high, but the levels became normal spontaneously despite continued breastfeeding, which endorses a “watchful waiting” strategy in managing asymptomatic infants with BMJ.

scholarly journals Presentation and Management of Liraglutide-Related Pancreatitis: Systematic Review of Case Reports

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A418-A418
Author(s):  
Som P Singh ◽  
Fahad Qureshi
Keyword(s):  
Systematic Review ◽  
Acute Pancreatitis ◽  
Systematic Reviews ◽  
Serum Amylase ◽  
Age Of Onset ◽  
Case Reports ◽  
Meta Analysis ◽  
Elevated Serum ◽  
Duration Of Treatment ◽  
Significant Difference

Abstract Background: Liraglutide is a glucagon-like peptide-1 (GLP-1 agonist) aimed towards promoting glucose-dependent insulin secretions. This medication is an emerging treatment option for the management of obesity through promoting satiety. However, there are a growing number of cases noting adverse effects of liraglutide. Of note, liraglutide has been seen to elevate serum amylase and lipase levels among users, and therefore promoting acute pancreatitis. Moreover, the overall presentation of liraglutide-related acute pancreatitis can be variable. The aim of this study is to determine qualitative patterns of presentation and meta-analysis of lab changes among acute pancreatitis patients on liraglutide. Methodology: Systematic review of the literature was performed on MEDLINE, Google Scholar, and the Cochrane Database of Systematic Reviews for liraglutide-related acute pancreatitis case studies, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. Meta-Analysis performed using Stata. Results: Twenty-one patient cases were identified then contingently evaluated for acute pancreatitis based on presentation, labs, and treatment outcomes. Within the pancreatitis cases, the average age of onset was 59 ± 16.5 (male = 58 ± 24.5; female = 56 ± 24.6). Upon qualitative review, 14.3% of patients were asymptomatic but showed elevated serum amylase and lipase levels following liraglutide administration (p < 0.05). Among the symptomatic group, there was variation in the duration of liraglutide administration and reported compliance. There was no significant difference among treatment regimes between symptomatic and asymptomatic groups. Conclusion: Longer duration of liraglutide treatment without dose adjustment was notable to show elevated rises in both serum amylase and lipase. However, the variation of patient symptoms cannot be determined through the duration of treatment. Patient demographics do not seem to play a role in acute pancreatitis episodes. Future studies ought to focus on larger patient samples to further develop an understanding of treatment duration, presentation, and management of acute pancreatitis management after liraglutide administration.

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