Blood urea nitrogen as an early predictor of severity in acute pancreatitis

Background: Acute pancreatitis presents as acute abdominal pain and is usually associated with raised pancreatic enzyme levels in the blood or urine. Aims and objectives of the study was to evaluate the role of serial BUN measurement as an early prognostic marker of acute pancreatitis.Methods: From each patient detailed history was taken, general and systemic examination were done and relevant investigations were conducted. BUN was repeated after 24 hours and the change in the level of BUN was noted. Imaging in the form of CT after 72 hours of admission were performed in each patient. The severity of acute pancreatitis was gauged by modified CTSI and the same was compared to the change in BUN values over first 24 hours of admission.Results: Mean BUN values at ‘0’ hour in severe acute pancreatitis and non-severe acute pancreatitis were 31.91±6.79 and 15.44±5.95 mg/dl, respectively. The difference between the two groups was statistically significant with p value of <0.001. Similarly, the difference in BUN values at ‘24’ hours between the two groups was statistically significant. BUN value ≥23 mg/dl at ‘0’ hour was found to be the optimal cut off for determining the severity of pancreatitis with sensitivity of 91.3%. BUN ≥25 mg/dl at 24 hours was found to be the optimal cut-off for determining the severity of acute pancreatitis with sensitivity of 95.7%.Conclusions: BUN as a single marker for acute pancreatitis can be useful as it is easy to perform and cheap marker to predict severity without the need for complex calculations.

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Serum Procalcitonin in the Prediction of Severity and Outcome of Acute Pancreatitis

Bangladesh Critical Care Journal ◽

10.3329/bccj.v9i1.53051 ◽

2021 ◽

Vol 9 (1) ◽

pp. 16-21

Author(s):

Khan Md Nazmus Saqeb

Keyword(s):

Acute Pancreatitis ◽

Statistical Analysis ◽

Severe Disease ◽

High Sensitivity ◽

Biochemical Tests ◽

Single Marker ◽

Predicting Outcome ◽

The Mean ◽

The Difference

Background: Different modalities are available for predicting severity and outcome of acute pancreatitis. A single marker with high sensitivity and specificity is yet to be identified. Aim: This study intends to find out the utility of serum procalcitonin in predicting the severity and outcome of acute pancreatitis. Methods: 117 patients admitted with acute pancreatitis were included.Clinical parameters and biochemical tests were recorded on admission, on day-3 & day-5 of admission. CT scan was performed in all patients. Serum procalcitonin was done on admission. Multifactorial scores were calculated using these data.Every patient was followed for identification of organ failure or other complications. Statistical analysis was done with SPSS. Result: Among 117 patients, 67(57.3%) were male. Biliary, hypertriglyceridemia, alcohol, malignancy and post-ERCP complications were found as aetiology in 25(21.4%), 23(19.7%), 8(6.8%), 3(2.6%),2(1.7%) cases respectively. In 53(45.3%) cases no definite etiology could be found. 83(70.9%) patients had mild,15(12.8%) had moderately severe and 19(16.2%) had severe acute pancreatitis. 23(19.65%) patients developed complication, whereas 94 (80.34%) developed none. The mean serum procalcitonin(pg/ml) of patients with mild, moderately severe and severe disease was 146±165.21, 1297±439.44, 4361±1493.55 respectively. The difference among the groups were statistically significant. Mean serum procalcitonin(pg/ml) in patientswho developed complications was 3744±1827.05 and in those without complication it was 301±559.97.ROC curve evaluating the role of serum procalcitonin in predicting outcome of acute pancreatitis showed AUC of 0.985. A cutoff point of 1131.28pg/ml showed highest sensitivity (95.7%) & specificity (94.7%). Conclusion: Serum procalcitonin can be a new promising marker to predict severity and outcome of acute pancreatitis. Bangladesh Crit Care J March 2021; 9(1): 16-21

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Regulation of HSP60 and the role of MK2 in a new model of severe experimental pancreatitis

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00225.2009 ◽

2009 ◽

Vol 297 (5) ◽

pp. G981-G989 ◽

Cited By ~ 20

Author(s):

Yong-Yu Li ◽

Stephanie Ochs ◽

Zhi-Rong Gao ◽

Antje Malo ◽

Chang-Jie Chen ◽

...

Keyword(s):

Acute Pancreatitis ◽

Severe Acute Pancreatitis ◽

Inflammatory Responses ◽

Pancreatic Enzyme ◽

Homozygous Deletion ◽

Experimental Pancreatitis ◽

Wild Type ◽

New Model ◽

Response Expression

The objective of this study was to investigate the role of MAPKAP kinase 2 (MK2) and heat shock protein (HSP) HSP60 in the pathogenesis of a new model of severe acute pancreatitis (AP). MK2 plays a significant role in the regulation of cytokines. It has been shown that induction and expression of several HSPs can protect against experimental pancreatitis. Interplay between both systems seems of high interest. Mice with a homozygous deletion of the MK2 gene were used. Severe AP was induced by combined intraperitoneal injections of cerulein with lipopolysaccharide (LPS). Severity of AP was assessed by biochemical markers and histology. The serum IL-6 and lung myeloperoxidase (MPO) levels were determined for assessing the extent of systemic inflammatory response. Expression of HSP25, HSP60, HSP70, and HSP90 was analyzed by Western blotting. Repeated injections of cerulein alone or cerulein plus LPS (Cer+LPS) resulted in local inflammatory responses in the pancreas and corresponding systemic inflammatory changes with pronounced severity in the Cer+LPS group. Compared with the C57Bl wild-type mice, the MK2−/− mice presented with significant milder pancreatitis and attenuated responses of serum amylase and trypsinogen activity. Furthermore, serum IL-6 was decreased as well as lung MPO activity. Injection of LPS alone displayed neither pancreatic inflammatory responses nor alterations of pancreatic enzyme activities but evidently elevated serum IL-6 levels and increased lung MPO activity. In contrast hereto, in the MK2−/− mice, these changes were much milder. Increased expression of HSP25 and HSP60 occurred after induction of AP. Especially, HSP60 was robustly elevated after Cer+LPS treatment, in both MK2−/− and wild-type mice. Thus the homozygous deletion of the MK2 gene ameliorates the severity of acute pancreatitis and accompanying systemic inflammatory reactions in a new model of severe acute pancreatitis. Our data support the hypothesis that MK2 participates in the multifactorial regulation of early inflammatory responses in AP, independently of the regulation of stress proteins like HSP25 and HSP60 and most likely due to its effect on cytokine regulation.

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Emerging role of resveratrol in the treatment of severe acute pancreatitis

Frontiers in Bioscience ◽

10.2741/s54 ◽

2010 ◽

Vol S2 (1) ◽

pp. 168-175 ◽

Cited By ~ 3

Author(s):

Qingyong Ma

Keyword(s):

Acute Pancreatitis ◽

Severe Acute Pancreatitis

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A STUDY TO ASSESS PREDICTIVE ROLE OF C-REACTIVE PROTEIN IN EARLY PREGNANCY AMONG WOMEN

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i8.2084 ◽

2021 ◽

Vol 5 (8) ◽

Author(s):

Neeti Mahla ◽

Mukesh Choudhary

Keyword(s):

Early Pregnancy ◽

Quantitative Estimation ◽

First Trimester ◽

Normal Pregnancy ◽

P Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Predictive Role ◽

The Difference

Background: To Assess Predictive Role of C-Reactive Protein In Early Pregnancy among Women Methods: Hospital based comparative analysis was conducted on Women with early pregnancy upto 14 weeks with either abdominal pain or vaginal bleeding or suspected extrauterine pregnancy. C-reactive protein (CRP) quantitative estimation is done by turbi-diametric method. Collected samples were sent to a designated lab of our hospital. Results: The mean c-reactive protein level in cases 2.31 with min-max value ranging from 0.80-3.91mg/dl while in controls mean c-reactive protein value came to be 9.12 with min-max range from 3.21-24.16 mg/dl. The difference between the two groups is significant as p value is less than 0.001. Conclusion: Our results of significantly increased CRP levels in normal pregnancy and a clear association between CRP and normal pregnancy, support the clinical application of this diagnostic tool in early pregnancy, especially as a predictor of abnormal first trimester pregnancies. Keywords: CRP, Pregnancy, Women

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Comparison of BISAP score with Ranson’s score in predicting severe acute pancreatitis

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v18i3.15306 ◽

2016 ◽

Vol 18 (3) ◽

pp. 44

Author(s):

D Karki ◽

T Tamang ◽

D Maharjan ◽

P Thapa ◽

S Shrestha

Keyword(s):

Acute Pancreatitis ◽

Severe Acute Pancreatitis ◽

Scoring System ◽

Laboratory Data ◽

P Value ◽

Severe Pancreatitis ◽

Common Etiology ◽

Sensitivity Specificity

Objectives: To compare BISAP score with Ranson’s scoring in predicting severity of acute pancreatitisMethods: Extensive demographic, radiographic, and laboratory data from consecutive patients with AP admitted to our institution was collected between March 2014 to March 2015. Ranson’s and BISAP score was calculated. Severity of pancreatitis was defined according to Atlanta classification. Sensitivity, Specificity, PPV, NPV of both the scoring system was calculated and compared.Results: A total of 42 patients with diagnosis of acute pancreatitis were included during the study period. 21(50%) were male and 21(50%) were female. Mean age is 49.52 ± 17.37.Most common etiology was biliary (45%) followed by alcohol (31%). 20 (48%) patients were categorized as severe pancreatitis according to Atlanta classification. 21 (50%) patients had a Ranson’s score of ≥3 and 19 (45.24%) patients had a BISAP score of ≥3. Both Ranson’s and BISAP scoring system was statistically significant in determining SAP ( p-value = 0.002). Sensitivity, specificity, PPV and NPV of Ranson’s and BISAP score was calculated to be 75%, 72.72%, 71.43%, 76.19% and 70%, 77.27%, 73.68%, 73.91%. respectively. The AUC for SAP by Ranson’s score is 0.7386 ; 95%CI (0.602 - 0.874) and BISAP score is 0.7364 ; 95% CI ( 0.599 - 0.872).Conclusions: Both Ranson’s and BISAP scoring system is similar in predicting SAP. However BISAP has the advantage due to its simplicity.

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