A Rare Entity in the Emergency Department: Normal Serum Lipase Level in Acute Pancreatitis

2015 ◽  
Author(s):  
Onder Limon
Keyword(s):  
Emergency Department ◽  
Acute Pancreatitis ◽  
Normal Serum ◽  
Rare Entity ◽  
Serum Lipase

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 A case of acute pancreatitis with normal serum lipase

2016 ◽  
Vol 43 (3) ◽  
pp. 162-164
Author(s):  
Afroja Alam ◽  
Mohammad Ferdous Ur Rahman ◽  
Mahbubur Rahman ◽  
Abed Hussain Khan ◽  
Mohammad Mainul Hasan Chowdhury ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Case History ◽  
Epigastric Pain ◽  
Normal Serum ◽  
Pancreatic Enzymes ◽  
Middle Aged ◽  
Serum Lipase ◽  
History Of

Patients with acute pancreatitis typically present with epigastric pain. In such patients, demonstration of elevated pancreatic enzymes and swollen pancreas by radiological investigations are sufficient to confirm the diagnosis. Here we present case history of a middle aged man who had epigastric pain, fever and swollen pancreas but enzyme levels were normal. He responded to conventional conservative treatment.Bangladesh Med J. 2014 Sep; 43 (3): 162-164

A Rapid and Sensitive Turbidimetric Method for Serum Lipase Based Upon Differences Between the Lipases of Normal and Pancreatitis Serum

1963 ◽  
Vol 9 (2) ◽  
pp. 168-181 ◽  
Author(s):  
William C Vogel ◽  
Leslie Zieve
Keyword(s):  
Acute Pancreatitis ◽  
Sodium Deoxycholate ◽  
Normal Serum ◽  
Serum Lipase ◽  
Turbidimetric Method ◽  
Emulsifying Agent ◽  
Salt Requirement ◽  
Optimal Action ◽  
Optimal Ph

Abstract A rapid turbidimetric method for the determination of serum lipase is described. The substrate is a nearly pure triglyceride in Tris buffer, with sodium deoxycholate as the emulsifying agent. The method is equal in sensitivity to the titrimetric measure of serum lipase using a modified Cherry-Crandall substrate. The serum of patients with acute pancreatitis contains a lipase with optimal action at pH 9.1 and sodium deoxycholate concentration of 0.35%. These are different from the optimal pH and bile salt requirement for lipase activity in normal serum or duodenal contents.

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 Normal levels of serum pancreatic enzymes in patients with progressive familial intrahepatic cholestasis type 2.

2010 ◽  
Vol 57 (4) ◽  
Author(s):  
Jaroslaw Walkowiak ◽  
Irena Jankowska ◽  
Aleksandra Lisowska ◽  
Maciej Biczysko ◽  
Aldona Wierzbicka ◽  
...  
Keyword(s):  
Intrahepatic Cholestasis ◽  
Elevated Serum ◽  
Normal Serum ◽  
Pancreatic Enzymes ◽  
Serum Lipase ◽  
Progressive Familial Intrahepatic Cholestasis ◽  
Elastase 1 ◽  
Pancreatic Damage ◽  
High Prevalence

High prevalence of elevated serum pancreatic enzymes in children with cholestasis with normal fecal elastase-1 concentrations has been documented. However, this state is related predominantly to biliary atresia. Therefore, we aimed to assess pancreatic damage by measuring serum pancreatic enzymes in patients with progressive familial intrahepatic cholestasis type 2 (PFIC type 2). Twenty PFIC type 2 patients with normal serum bilirubin and bile acid concentrations were included in the study. Thirty pancreatic insufficient cystic fibrosis (PI-CF) patients, thirty patients with acute pancreatitis (AP) and thirty healthy subjects (HS) served for the purpose of comparison. In all subjects, serum lipase and elastase-1 levels were measured. In all but one PFIC type 2 patients and all HS normal lipase activities were found. Serum elastase-1 concentrations were normal in all PFIC type 2 patients and HS. The enzyme levels were very similar in both groups studied. Lipase activities in PFIC type 2 patients were significantly higher than in PI-CF patients (p < 0.00001) and lower than in patients with AP (p < 0.00001). Serum elastase-1 levels in PFIC type 2 patients were significantly lower than in patients with AP (p < 0.00001) and not different from those in PI-CF patients. In conclusion. serum pancreatic enzymes in patients with PFIC type 2 are normal. No pancreatic damage in these patients could be detected.

scholarly journals Chymase as a Novel Therapeutic Target in Acute Pancreatitis

2021 ◽  
Vol 22 (22) ◽  
pp. 12313
Author(s):  
Toru Kuramoto ◽  
Denan Jin ◽  
Koji Komeda ◽  
Kohei Taniguchi ◽  
Fumitoshi Hirokawa ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Therapeutic Agent ◽  
Mrna Level ◽  
Survival Rates ◽  
Treated Group ◽  
Serum Lipase ◽  
Group A ◽  
Factor Α ◽  
Chymase Inhibitor ◽  
Novel Therapeutic

Acute pancreatitis is still a life-threatening disease without an evidenced therapeutic agent. In this study, the effect of chymase in acute pancreatitis and the possible effect of a chymase inhibitor in acute pancreatitis were investigated. Hamsters were subcutaneously administered 3.0 g/kg of L-arginine to induce acute pancreatitis. Biological markers were measured 1, 2, and 8 h after L-arginine administration. To investigate the effect of a chymase inhibitor, a placebo (saline) or a chymase inhibitor TY-51469 (30 mg/kg) was given 1 h after L-arginine administration. The survival rates were evaluated for 24 h after L-arginine administration. Significant increases in serum lipase levels and pancreatic neutrophil numbers were observed at 1 and 2 h after L-arginine administration, respectively. Significant increases in pancreatic neutrophil numbers were observed in the placebo-treated group, but they were significantly reduced in the TY-51469-treated group. A significant increase in the pancreatic tumor necrosis factor-α mRNA level was observed in the placebo-treated group, but it disappeared in the TY-51469-treated group. Chymase activity significantly increased in the placebo-treated group, but it was significantly reduced by treatment with TY-51469. The survival rate significantly improved in the TY-51469-treated group. A chymase inhibitor may become a novel therapeutic agent for acute pancreatitis.

scholarly journals A rare entity of acute bilateral cortical renal necrosis following acute pancreatitis

2015 ◽  
Vol 8 (4) ◽  
pp. 540
Author(s):  
ShwetangM Solanki ◽  
BhavikK Shah ◽  
KrutiD Dave ◽  
RuchitB Patel ◽  
BhavinJ Patel
Keyword(s):  
Acute Pancreatitis ◽  
Rare Entity ◽  
Renal Necrosis

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.

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