scholarly journals A comparative analysis of urine trypsinogen-2 test strip with serum lipase and serum amylase in diagnosis of acute pancreatitis

2021 ◽  
Vol 8 (10) ◽  
pp. 2921
Author(s):  
Satish Kumar R. ◽  
Ashik Aslam ◽  
Nitish S. ◽  
Gagan S. Prakash
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
High Sensitivity ◽  
Test Strip ◽  
Serum Lipase ◽  
Emergency Presentation ◽  
High Negative Predictive Value ◽  
Set Up ◽  
High Degree ◽  
Symptoms And Signs

Background: Acute pancreatitis possess difficulty in diagnosis in its emergency presentation. Hence segregation of this disease from other specific or non-specific causes of acute abdomen is important. In majority of the suspected cases, the urinary trypsinogen-2 test strip can be used to detect this disease, especially in emergency set-up. The aim and objective of the study was to evaluate the sensitivity and specificity of urinary trypsinogen-2 and to compare it with that of the standard biochemical markers of acute pancreatitis serum amylase and serum lipase.Methods: All patients who presented to the surgical emergency with symptoms and signs suspicious of acute pancreatitis were included in the study, rapid urinary trypsinogen-2 test was done immediately at the bed side, serum amylase and lipase was send for all cases along with routine investigations.Results: The urinary trypsinogen-2 test was sensitive in 96.1% cases and specific in 82.6% cases. The sensitivity is superior to that of serum lipase (sensitivity-90.2%) and serum amylase (sensitivity-84.3%). The high sensitivity of the urinary trypsinogen-2 test resulted in very high negative predictive value of 90.5%, hence a negative test almost rules out the diagnosis of acute pancreatitis.Conclusions: In patients with acute abdominal pain with suspicion of acute pancreatitis seen in emergency department, a negative dipstick for urinary trypsinogen-2 rules out acute pancreatitis with high degree of probability and therefore appears to be more suitable for screening of acute pancreatitis.

CAPD and Pancreatitis: No Connection

1992 ◽  
Vol 12 (3) ◽  
pp. 309-316 ◽  
Author(s):  
Amit Gupta ◽  
Zheng Vuan ◽  
Elias V. Balaskas ◽  
Ramesh Khanna ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Pancreatic Secretory Trypsin Inhibitor ◽  
Serum Lipase ◽  
High Index Of Suspicion ◽  
Acute And Chronic Pancreatitis ◽  
Symptoms And Signs ◽  
Capd Patient ◽  
Uncommon Complication

Autopsy studies have shown that approximately 56% of patients on long-term continuous ambulatory peritoneal dialysis (CAPD) develop various pancreatic abnormalities, such as acute and chronic pancreatitis, fibrosis, and acinar dilatation. This prevalence of anatomical abnormalities is similar to that observed in patients on hemodialysis and higher than that in those with normal renal function. However, clinical acute pancreatitis is an uncommon complication of CAPD (0.9%), and this prevalence is similar to that (1.7%) of patient son hemodialysis. We can attribute acute pancreatitis in CAPD patients to no single factor. Perhaps preexisting anatomical abnormalities of the pancreas make the CAPD patient susceptible to acute pancreatitis when exposed to a variety of physiological and non physiological influences. The diagnosis of acute pancreatitis in CAPD patients is difficult, because symptoms and signs are similar to those of dialysis-associated peritonitis. Serum amylase values three times greater than the upper limit of normal and effluent amylase greater than 100 U/L suggest the diagnosis of acute pancreatitis. Serum lipase, isoamylase, and pancreatic secretory trypsin inhibitor are not helpful. In confirming the diagnosis, a computed tomography (CT) scan is more helpful than ultrasound, although it is positive in only 50–60% of cases. One should harbor a high index of suspicion concerning acute pancreatitis if a CAPD patient presenting with suspected peritonitis has either a negative effluent culture or does not respond to antibiotic therapy.

scholarly journals A comparative analysis of urine trypsinogen-2 test strip with serum lipase in diagnosis of acute pancreatitis in emergency set-up

2018 ◽  
Vol 6 (1) ◽  
pp. 252
Author(s):  
Jagmohan Mishra ◽  
Biplab Mishra ◽  
Afroza Firodous
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
High Specificity ◽  
Test Strip ◽  
Confirmatory Test ◽  
Serum Lipase ◽  
Reference Limit ◽  
Set Up ◽  
Upper Reference Limit

Background: Acute pancreatitis possess difficulty in diagnosis in its emergency presentation. Hence to segregate this disease is important from other specific or non-specific causes of acute abdomen. Hence in suspected cases in majority of patients the urinary trypsinogen-2 test strip (Actim pancreatitis) can be used to detect this disease, especially in emergency set-up. The result of the strip test is then corroborated with findings of serum lipase in the blood.Methods: Author prospectively compared 205 consecutive patients with acute abdominal pain admitted to the casualty, SCB Medical College and Hospital. The patients were tested on admission with the Actim pancreatitis test strip. Serum amylase, serum lipase, and urine trypsinogen-2 concentrations were also determined quantitatively.Results: The Actim pancreatitis test strip was sensitive in 93% cases and specific in 92% cases. This was superior to that of serum lipase (sensitivity 77% and specificity 87%). With a cut-off >3x the upper reference limit, the sensitivity of serum lipase was only 52% while the specificity was 98%. The high sensitivity for the Actim pancreatitis test strip resulted in every high negative predictive value of 99%.Conclusions: In patients with acute abdominal pain seen in emergency department, a negative dipstick for urinary trypsinogen-2 rules out acute pancreatitis with high degree of probability and therefore appears to be more suitable for screening of acute pancreatitis. With its high specificity with a cut-off >3x the upper reference limit, serum lipase is suitable as a confirmatory test for pancreatitis when a positive dipstick result is obtained.

scholarly journals The role and importance of biochemical markers in diagnosis of alcoholic acute pancreatitis

2012 ◽  
Vol 65 (3-4) ◽  
pp. 152-157
Author(s):  
Snezana Tesic-Rajkovic ◽  
Biljana Radovanovic-Dinic ◽  
Tatjana Jevtovic-Stoimenov
Keyword(s):  
Acute Pancreatitis ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Biochemical Markers ◽  
Biochemical Parameters ◽  
Serum Amylase ◽  
Alcoholic Pancreatitis ◽  
Serum Lipase ◽  
Acute Alcoholic Pancreatitis ◽  
Biochemical Analyses

Introduction. Alcoholic acute pancreatitis occurs in 10% of alcoholics, who take more than 80g alcohol daily. Different biochemical markers are used to diagnose acute pancreatitis, and some of them may help in establishing etiology of acute pancreatitis. Material and Methods. This study is a prospective review of 21 patients. All patients were hospitalized at the Department for Gastroenterology and Hepatology or at the Department for Surgery of the Clinical Centre of Nis in the period from August 1st 2009 to March 1st 2010 with diagnosis of acute alcoholic pancreatitis. Detailed anamnesis, clinical examination, biochemical analyses and ultrasonography of the upper abdomen were done in all patients. All patients provided data on alcohol abuse. Results. The analysis of the corresponding biochemical parameters revealed a statistically significant correlation between the following values: serum amylase and serum lipase (R=0.964674; p<0.001), cholesterol and triglycerides (R=0.93789; p<0.001), total and direct bilirubin (R=0.857899; p<0.001) and between aspartate aminotransferase and alanine aminotransferase (R=0.824461, p<0.001) in patients with alcoholic acute pancreatitis. In addition, there was a statistically significant correlation between the values of serum amylase and urinary amylase (R=0.582742, p<0.001). Discussion. The analysis of biochemical markers showed that some of them were significant for beforehand diagnosis of alcoholic acute pancreatitis, which is in accordance with other studies. Conclusion Some biochemical parameters can be potential predictors of alcoholic acute pancreatitis (lipase/amylase ratio >2, greater ratio of aspartate aminotransferase/ alanine aminotransferase, enhanced triglycerides and values of mean corpuscular volume.

scholarly journals Acute Pancreatitis: An Atypical Presentation

2017 ◽  
Vol 11 (2) ◽  
pp. 359-363 ◽  
Author(s):  
Omar Nadhem ◽  
Omar Salh
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Reports ◽  
Case Series ◽  
Normal Serum ◽  
Intravenous Fluids ◽  
Serum Enzyme ◽  
Serum Lipase ◽  
Upper Abdominal ◽  
Symptoms And Signs

Acute pancreatitis is an important cause of acute upper abdominal pain. Because its clinical features are similar to a number of other acute illnesses, it is difficult to make a diagnosis only on the basis of symptoms and signs. The diagnosis of acute pancreatitis is based on 2 of the following 3 criteria: (1) abdominal pain consistent with pancreatitis, (2) serum lipase and/or amylase ≥3 times the upper limit of normal, and (3) characteristic findings from abdominal imaging. The sensitivity and specificity of lipase in diagnosing acute pancreatitis are undisputed. However, normal lipase level should not exclude a pancreatitis diagnosis. In patients with atypical pancreatitis presentation, imaging is needed. We experienced two cases of acute pancreatitis associated with normal serum enzyme levels. Both patients were diagnosed based on clinical and radiological evidence. They were successfully treated with intravenous fluids and analgesics with clinical and laboratory improvement. The importance of this case series is the unlikely presentation of acute pancreatitis. We believe that more research is needed to determine the exact proportion of acute pancreatitis patients who first present with normal serum lipase, since similar cases have been seen in case reports.

scholarly journals Clinical pattern of acute pancreatitis in eastern India and comparison of Ranson, BISAP and APACHE II as a predictor of severity, local complications and mortality

2018 ◽  
Vol 5 (11) ◽  
pp. 3707 ◽  
Author(s):  
Nishith M. Paul Ekka ◽  
Gaurav Mishra ◽  
Vinod Kumar ◽  
Arun Kumar Tiwary ◽  
Tanushree Kar ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Hospital Admissions ◽  
Scoring Systems ◽  
Apache Ii ◽  
Aetiological Factor ◽  
Serum Lipase ◽  
Clinical Pattern ◽  
Local Complications ◽  
Complications And Mortality

Background: Acute pancreatitis is the single most frequent gastrointestinal cause of hospital admissions. Scoring systems have been used since the 1970s for assessment of its severity. This study was aimed to assess the clinical pattern of acute pancreatitis and to compare various predicting systems like Ranson, BISAP and APACHE II in predicting severity, local complications and mortality in acute pancreatitis.Methods: In this prospective study, 91 consecutive cases of acute pancreatitis admitted, between April 2015 to March 2017, were studied. The diagnostic criteria include the presence of at least two of the three features; abdominal pain, serum amylase and lipase levels and findings on imaging studies. Patients were divided into two groups each, BISAP Ranson ≥3 and <3, APACHE II ≥8 and <8, and analyzed statistically.Results: Out of total of 91 patients, 81 were male and 14 were female with mean age was 36.14 years. Commonest aetiological factor was alcoholism in 57.89% followed by gallstones in 23.16%. Serum amylase was raised in 83.26% patients while 95.79% had raised serum lipase levels. 75.79% patients were of MAP while 24.21% patients were of MSAP and SAP. 7.37% patients developed local complications and mortality rate was 6.32%. All the scoring systems were found similar in predicting severity, local complication and mortality, had low sensitivity and high specificity (P value < 0.05).Conclusions: There is no ideal predicting system for acute pancreatitis. These scoring systems can be used to triage patients for better healthcare delivery.

Comparison of urine trypsinogen-2 test strip with serum lipase in the diagnosis of acute pancreatitis

2000 ◽  
Vol 118 (4) ◽  
pp. A162 ◽  
Author(s):  
Marja-Leena Kylanpaa-Back ◽  
Esko Kemppainen ◽  
Pauli A. Puolakkainen ◽  
Johan Hedstrom ◽  
Reijo Haapiainen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Test Strip ◽  
Serum Lipase

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.

scholarly journals STUDY OF SERUM LIPASE TO AMYLASE RATIO IN DIFFERENTIATING BETWEEN ACUTE ALCOHOLIC AND NON-ALCOHOLIC PANCREATITIS

2020 ◽  
pp. 1-2
Author(s):  
Sudhansu Sarkar ◽  
Bala Krishna Havligi
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Imaging Modality ◽  
Severe Disease ◽  
Treatment Protocol ◽  
Fold Increase ◽  
Alcoholic Pancreatitis ◽  
Serum Lipase ◽  
Gall Stones ◽  
Overall Mortality

Acute pancreatitis (AP) is a common condition involving the pancreas. The estimated incidence is about 3% of cases presenting with pain in abdomen.(4) Gall stones and alcoholism together account for 80% of acute pancreatitis.(5) Although the overall mortality rate for acute pancreatitis is 2-10% and this is primarily related to the 10-30% of patients with severe disease characterized by pancreatic and peripancreatic necrosis.(6) Diagnosis remains clinical and can be supported by 1.5 - 2 fold increase above the upper limit of normal of serum amylase and lipase.(10) Amylase and lipase levels are known to be the most important factors in determining acute pancreatitis. It is well known that these levels are usually elevated in acute pancreatitis, without regard to whether it is of biliary type or alcoholic type. Furthermore whether or not these levels can be used to discern between the two types, has been also a matter of concern. It has been reported that the lipase/amylase ratio could be a new index distinguishing two types of pancreatitis, with the critical value being 2. This report had been followed by some debate between supporters and opponents. Currently CECT is the imaging modality of choice where areas of hypo perfusion correlate with necrosis. (11) It can’t differentiate between alcoholic and non-alcoholic AP. Identification of two groups could help formulating treatment protocol for either group. The aim of the present study is to establish the utility of the ratio of the serum lipase and serum amylase, a new index distinguishing acute episode of alcoholic from non alcoholic pancreatitis.

scholarly journals A retrospective study of clinical efficacy of serum lipase/amylase ratio in predicting etiology of acute pancreatitis

2018 ◽  
Vol 5 (4) ◽  
pp. 1365
Author(s):  
Harish Kumar C. ◽  
Mridul G. S.
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Serum Amylase ◽  
Imaging Techniques ◽  
Group Versus ◽  
Amylase Level ◽  
Serum Lipase ◽  
Serum Amylase Level ◽  
Alcohol Group ◽  
Male Predominance

Background: The serum lipase/amylase (L/A) ratio had been proposed to distinguish the etiology of pancreatitis, the efficacy to predict the etiology of acute pancreatitis is assessed in our study as it may need different therapeutic approaches.Methods: From January 2017 to December 2017, 54 patients with acute pancreatitis were included 48 (88.9%) men and 6 (11.1%) women with a mean age of 39.2 years, ranging from 18 to 90 years. They were divided into 2 subgroups as alcohol (n=27), nonalcoholic (n=27), and their serum L/A ratio level were compared with a mean age 39.42±9.9 years in alcoholic group versus 39.04 ± 7.7 years in nonalcoholic group.Results: Male predominance in alcoholic and nonalcoholic group and all female patients (100%) etiology is nonalcoholic. The elevation of serum amylase level in nonalcoholic group on average is 600 versus in alcoholic group 512 and serum lipase level average in nonalcoholic group 766 versus in alcohol group 629. Instead, the serum L/A ratio showed no significant changes among each group. In this study, the alcoholic acute pancreatitis is more severe than nonalcoholic pancreatitis. There was also no statistically significant (p=0.90) difference in serum L/A ratio in alcoholic and nonalcoholic pancreatitis.Conclusions: The serum amylase and lipase concentrations are not able to establish etiology acute pancreatitis as assessed by imaging techniques. The L/A ratio is not a good predictive factor in distinguishing acute episode of alcoholic and non-alcoholic acute pancreatitis.

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