Serological diagnosis and prognosis of severe acute pancreatitis by analysis of serum glycoprotein 2

2017 ◽  
Vol 55 (6) ◽  
pp. 854-864 ◽  
Author(s):  
Dirk Roggenbuck ◽  
Alexander Goihl ◽  
Katja Hanack ◽  
Pamela Holzlöhner ◽  
Christian Hentschel ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Neoplasms ◽  
Positive Likelihood Ratio ◽  
Specific Marker ◽  
Zymogen Granule ◽  
Biliary Disease ◽  
C Reactive Protein ◽  
Assay Sensitivity ◽  
Reactive Protein

Abstract Background: Glycoprotein 2 (GP2), the pancreatic major zymogen granule membrane glycoprotein, was reported to be elevated in acute pancreatitis in animal models. Methods: Enzyme-linked immunosorbent assays (ELISAs) were developed to evaluate human glycoprotein 2 isoform alpha (GP2a) and total GP2 (GP2t) as specific markers for acute pancreatitis in sera of 153 patients with acute pancreatitis, 26 with chronic pancreatitis, 125 with pancreatic neoplasms, 324 with non-pancreatic neoplasms, 109 patients with liver/biliary disease, 67 with gastrointestinal disease, and 101 healthy subjects. GP2a and GP2t levels were correlated with procalcitonin and C-reactive protein in 152 and 146 follow-up samples of acute pancreatitis patients, respectively. Results: The GP2a ELISA revealed a significantly higher assay accuracy in contrast to the GP2t assay (sensitivity ≤3 disease days: 91.7%, specificity: 96.7%, positive likelihood ratio [LR+]: 24.6, LR–: 0.09). GP2a and GP2t levels as well as prevalences were significantly elevated in early acute pancreatitis (≤3 disease days) compared to all control cohorts (p<0.05, respectively). GP2a and GP2t levels were significantly higher in patients with severe acute pancreatitis at admission compared with mild cases (p<0.05, respectively). Odds ratio for GP2a regarding mild vs. severe acute pancreatitis with lethal outcome was 7.8 on admission (p=0.0222). GP2a and GP2t levels were significantly correlated with procalcitonin [Spearman’s rank coefficient of correlation (ρ)=0.21, 0.26; p=0.0110, 0.0012; respectively] and C-reactive protein (ρ=0.37, 0.40; p<0.0001; respectively). Conclusions: Serum GP2a is a specific marker of acute pancreatitis and analysis of GP2a can aid in the differential diagnosis of acute upper abdominal pain and prognosis of severe acute pancreatitis.

Clinical effects of hemoadsorption with CytoSorb® in patients with severe acute pancreatitis: A case series

2019 ◽  
Vol 42 (4) ◽  
pp. 190-193 ◽  
Author(s):  
Dana Tomescu ◽  
Mihai Popescu ◽  
Corina David ◽  
Simona Dima
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Case Series ◽  
Clinical Effects ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Continuous Venovenous Hemodiafiltration ◽  
Vasopressor Support ◽  
Before And After ◽  
Organ Dysfunctions

Hemoadsorption using CytoSorb® has recently gained attention as a new therapy aimed at modulating the inflammatory response syndrome in critically ill patients. The aim of our study was to assess the clinical effects of CytoSorb in patients with severe acute pancreatitis. We prospectively included 12 patients admitted to the intensive care unit for severe acute pancreatitis. After inclusion, continuous venovenous hemodiafiltration in conjunction with CytoSorb was applied. Clinical data, number of organ dysfunctions, paraclinical data, and vasopressor support were collected before and after the treatment. The use of CytoSorb was associated with a decrease in C-reactive protein from 242 (30, 300) to 180 (20, 252) mg/L (p = 0.04) and procalcitonin from 2.21 (0.01, 15.02) to 1.10 (0.01, 3.79) ng/mL (p = 0.02). The median vasopressor support was 0.1 (0, 0.9) mg/h at the beginning of the treatment and it was discontinued in all cases after the treatment. In conclusion, the use of CytoSorb in patients with severe acute pancreatitis was associated with improved hemodynamics and decreased inflammatory markers.

Clinical Effect and Safety of Endoscopic Ultrasound-Guided Laparoscopic Catheter Drainage for Severe Acute Pancreatitis

2020 ◽  
Vol 10 (8) ◽  
pp. 1899-1904
Author(s):  
Minzhen Qin ◽  
Zhihai Liang ◽  
Huiying Yang ◽  
Guoduo Tang ◽  
Mentula A Kalevi
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Endoscopic Ultrasound ◽  
Clinical Effect ◽  
White Blood Cells ◽  
The Body ◽  
C Reactive Protein ◽  
Ultrasound Guided ◽  
Catheter Drainage ◽  
Reactive Protein

In order to study the clinical effect and safety of endoscopic ultrasound-guided laparoscopic catheter drainage for severe acute pancreatitis, the patients with severe acute pancreatitis were selected as the research objects, the laparoscopic catheter drainage under the guidance of endoscopic ultrasound was carried out, and the efficacy and safety of the operation were evaluated. The results showed that after endoscopic ultrasound-guided laparoscopic catheterization and drainage, the number of C-reactive protein, procalcitonin and white blood cells was decreased, and the inflammation was improved after treatment; the body temperature of 45% patients returned to normal on the first day after operation, and 55% patients returned to normal on the third day after operation; only 1 case of patients followed up had infectious necrosis of pancreas. In summary, endoscopic ultrasound-guided laparoscopic catheter drainage is a safe and effective treatment for severe acute pancreatitis.

Serum profiles of M30, M65 and interleukin-17 compared with C-reactive protein in patients with mild and severe acute pancreatitis

2014 ◽  
Vol 21 (12) ◽  
pp. 911-918 ◽  
Author(s):  
Sotirios Vlachos ◽  
Alexandra K. Tsaroucha ◽  
Georgios Konstantoudakis ◽  
Fotini Papachristou ◽  
Gregory Trypsianis ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Interleukin 17 ◽  
C Reactive Protein ◽  
Reactive Protein

Comparison of sensitivity and specificity of serum poly-C avid ribonuclease activity and C-reactive protein concentration in detection of mild and severe acute pancreatitis

2004 ◽  
Vol 42 (5) ◽  
Author(s):  
Beata Kuśnierz-Cabala ◽  
Jerzy W. Naskalski ◽  
Boguslaw Kędra ◽  
Józefa Panek
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Clinical Course ◽  
Function Analysis ◽  
Necrotizing Pancreatitis ◽  
Ribonuclease P ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Acute Necrotizing ◽  
Mild Acute Pancreatitis

AbstractThe aim of this study was to compare diagnostic performance of C-reactive protein (CRP) and poly-C avid ribonuclease (P-RNase) levels in the prediction of a severe clinical course of acute pancreatitis (AP). The study included 36 patients with mild and 20 with severe AP. CRP concentration was measured by an immunonephelometric method and P-RNase activity by the rate of polycytidylate hydrolysis at pH 7.8. At the time of admission, both P-RNase and CRP levels were significantly increased in all patients when compared to healthy subjects (29.2 vs. 18.7 U/l and 91.1 vs. 2.89 mg/l; p<0.001). Up to days 3 and 4 a further increase in P-RNase was observed. On the other hand, the increase in CRP continued only through days 2 and 3 (p<0.001). Severe acute pancreatitis (SAP) and mild acute pancreatitis (MAP) differed significantly with respect to P-RNase levels on all days studied; whereas CRP levels differed significantly on days 2–5 but did not differ at admission. Receiver operating characteristic (ROC) curve function analysis yielded the best sensitivity of SAP detection for P-RNase, equaling 72.2%, at the cut-off point value 65.3 U/l on day 3 after admission. The sensitivity of CRP for detection of SAP was 85.0% at 125.7 mg/l on the 2nd day after admission. Both parameters studied were significantly associated with the severity of the AP clinical course; however, on days 1 and 2 postadmission, P-RNase was more specific for detection of SAP than CRP (94.4% vs. 77.1% on the 1st day and 94.4% vs. 55.5% on the 2nd day). In conclusion, P-RNase has shown an excellent performance for early differentiation of acute necrotizing pancreatitis.

Procalcitonin, C-reactive Protein, and Neutrophil Ratio Contribute to the Diagnosis and Prognosis of Severe Acute Pancreatitis

2020 ◽  
Author(s):  
Yi LIANG ◽  
Xianwei ZHAO ◽  
Fanliang MENG
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Peripheral Blood ◽  
Multivariate Logistic Regression Analysis ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Diagnosis And Prognosis ◽  
Mild Acute Pancreatitis ◽  
Medical University

Background: We aimed to explore the significance of procalcitonin (PCT), C-reactive protein (CRP) and neutrophil ratio (N%) in the early diagnosis, treatment, and prognosis of severe acute pancreatitis (SAP). Methods: A total of 104 patients with SAP (SAP group) and 101 patients with mild acute pancreatitis (MAP) (MAP group) admitted to Affiliated Hospital of Jining Medical University, Jining, China were enrolled. The PCT and CRP in serum were detected by a full-automatic biochemical analyzer, and N% in peripheral blood was measured by a hemocyte analyzer. Results: The peripheral blood PCT, CRP, and N% in the SAP group were significantly higher than those in the MAP group (P<0.001). Multivariate Logistic regression analysis showed that acute physiology and chronic health evaluation II (APACHE II) score, Ranson score, PCT, CRP, and N% were independent risk factors for SAP. The receiver operating characteristic (ROC) curve showed that the area under curve (AUC) of PCT, CRP, and N% in diagnosing SAP were 0.906, 0.840, and 0.834 respectively, while that of combined detection was 0.972. The AUC of PCT, CRP, and N% in diagnosing SAP death were 0.907, 0.900, and 0.894, respectively. Conclusions: Peripheral blood PCT, CRP, and N% contribute to the diagnosis and prognosis of SAP.

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