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.

scholarly journals Familial Chylomicronemia Syndrome-Induced Acute Necrotizing Pancreatitis during Pregnancy

2021 ◽  
Vol 43 (03) ◽  
pp. 220-224
Author(s):  
Julia Cristina Coronado Arroyo ◽  
Marcio José Concepción Zavaleta ◽  
Eilhart Jorge García Villasante ◽  
Mikaela Kcomt Lam ◽  
Luis Alberto Concepción Urteaga ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Clinical Course ◽  
Necrotizing Pancreatitis ◽  
Rare Condition ◽  
Severe Hypertriglyceridemia ◽  
Fetal Complications ◽  
Acute Necrotizing ◽  
History Of ◽  
Important Objective

AbstractAcute pancreatitis is a rare condition in pregnancy, associated with a high mortality rate. Hypertriglyceridemia represents its second most common cause. We present the case of a 38-year-old woman in the 24th week of gestation with a history of hypertriglyceridemia and recurrent episodes of pancreatitis. She was admitted to our hospital with acute pancreatitis due to severe hypertriglyceridemia. She was stabilized and treated with fibrates. Despite her favorable clinical course, she developed a second episode of acute pancreatitis complicated by multi-organ dysfunction and pancreatic necrosis, requiring a necrosectomy. The pregnancy was ended by cesarean section, after which three plasmapheresis sessions were performed. She is currently asymptomatic with stable triglyceride levels. Acute pancreatitis due to hypertriglyceridemia represents a diagnostic and therapeutic challenge in pregnant women, associated with serious maternal and fetal complications. When primary hypertriglyceridemia is suspected, such as familial chylomicronemia syndrome, the most important objective is preventing the onset of pancreatitis.

The burden of acute pancreatitis and early experience of step-up approach for acute necrotizing pancreatitis at Military Hospital

2019 ◽  
Vol 22 (2) ◽  
pp. 11-17
Author(s):  
Sushil Bahadur Rawal ◽  
Uttam Laudari ◽  
Basanta Khatiwada ◽  
Anup Thapa ◽  
Manoj Kumar Jha ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Necrotizing Pancreatitis ◽  
Early Experience ◽  
Acute Necrotizing Pancreatitis ◽  
Military Hospital ◽  
Army Hospital ◽  
Acute Necrotizing ◽  
Hospital Resources ◽  
Open Necrosectomy

Introduction: Twenty-five percent of acute pancreatitis develops severe acute pancreatitis (SAP). SAP patients have prolonged hospitalization and require a substantial amount of manpower and hospital resources. The aim of this study was to give an insight into the burden of acute pancreatitis at a tertiary level military hospital and to share the experience of managing pancreatic necrosis with the application of the step-up approach. Methods: A prospective descriptive study of consecutive patients was conducted at Shree Birendra Army Hospital from 2017 June to 2017 November. Patients with a diagnosis of acute pancreatitis admitted were stratified according to severity as per Revised Atlanta classification 2012. Patients with acute necrotizing pancreatitis were enrolled for the step-up approach. Patient’s demography, baseline investigations, radiology, prognostic scoring scales and type of intervention were analyzed. The burden of severe acute pancreatitis at our center and the early experience of the step-up approach at our centre within the study period were studied. Results: Out of 35 five patients with acute pancreatitis, 7 (20%) subsequently developed severe acute pancreatitis. Among them, five patients subsequently developed necrotizing pancreatitis who were managed according to the step-up approach. Out of them, three patients subsequently underwent operative intervention in the form of minimally invasive procedures like percutaneous drain placement, laparoscopic necrosectomy, video-assisted retroperitoneal debridement, and open necrosectomy. Conclusion: Acute pancreatitis is a common presentation at our centre. The step-up approach in the management of acute necrotizing pancreatitis is a safe and feasible approach.

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
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