scholarly journals Acute Pancreatitis with Normal Amylase: A Case Report

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Jinous Manouchehri ◽  
Yadollah Rashidi
Keyword(s):  
Acute Pancreatitis ◽  
Laboratory Tests ◽  
Diagnostic Method ◽  
Serum Amylase ◽  
Clinical Signs ◽  
Rapid Diagnosis ◽  
Clinical Suspicion ◽  
Diagnostic Methods ◽  
Therapeutic Outcomes

: Rapid diagnosis in patients with acute pancreatitis is essential to optimal therapeutic outcomes. Upon clinical suspicion, various methods could be used to confirm the diagnosis based on the symptoms and examinations. Laboratory tests are an important diagnostic method in this regard based on the increased serum amylase/lipase. In this study, we described the case of a 31-year-old male patient presenting with the clinical signs of pancreatitis with normal amylase and elevated triglyceride in the follow-up. In case of strong clinical suspicion, other tests and diagnostic methods are recommended to confirm acute pancreatitis.

scholarly journals Suboptimal management of hypertriglyceridemia in the outpatient setting is associated with the recurrent pancreatitis

2019 ◽  
Author(s):  
Ping Yan ◽  
Hong-Xian Zhao ◽  
xia chen
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Discharge ◽  
Serum Amylase ◽  
Outpatient Setting ◽  
Lipid Lowering ◽  
Recurrent Acute Pancreatitis ◽  
Increasing Risk ◽  
Few Data ◽  
Risk Of Relapse

Abstract Background Hyperlipemia is a well-established etiology of acute pancreatitis (AP). However, few data are available in the medical literature about the management of triglyceride levels in the outpatient setting in patients with hypertriglyceridemic acute pancreatitis (HTG-AP). We evaluated the blood triglyceride levels and the follow-up of triglyceride management in patients with HTG-AP.Methods This retrospective study enrolled patients with HTG-AP from January 2013 to March 2019 in Affiliated Hospital of Southwest Medical of University. By reviewing the hospitalization records and the follow-up data, the clinical features, blood triglyceride levels, lipid-lowering medications use and blood triglyceride levels monitoring after hospital discharge were analyzed.Results 133 patients (46 women, 87 men; median age at presentation 37.4 years) diagnosed with HTG-AP were enrolled in the study. 32 cases (24.1%) presented with recurrent acute pancreatitis (RAP). Patients who had RAP were younger and had higher blood triglyceride levels compared with that of single attack ( P < 0.05). No difference of serum amylase levels, hospitalization duration and mortality rate were observed between non-RAP and RAP. Lipid monitoring was only observed in 12.8% of patients and 10 patients(7.5%) took medications to control blood triglyceride levels after hospital discharge. The follow-up of triglyceride levels in the outpatient setting were higher in RAP patients than that of non-recurrent cases ( P < 0.05). Among the patients who had measured their triglyceride levels after discharge, 83.3% of patients with RAP had at least 1 follow-up of triglyceride level that higher than 500 mg/dL, while no patient had one HTG-AP attack displayed triglyceride levels higher than 500 mg/dL.Conclusions Triglyceride levels after hospital discharge higher than 500 mg/dL may be associated with an increasing risk of relapse of clinical acute pancreatitis events. Inappropriate management of triglyceride control in the outpatient setting may be associated with an increasing risk of relapse of clinical HTG-AP events.

scholarly journals A Rare Case: Gall Stone Induced Acute Pancreatitis with Normal Amylase and Lipase Levels

2020 ◽  
Vol 3 (2) ◽  
pp. 10-12
Author(s):  
Arindam Mukherjee ◽  
Govind Madhav ◽  
Ajay Tadha
Keyword(s):  
Acute Pancreatitis ◽  
Rare Case ◽  
Serum Amylase ◽  
Gall Stone ◽  
Clinical Suspicion

Acute pancreatitis (AP) is most commonly diagnosed by increased values of serum amylase and lipase. Acute pancreatitis where value of serum amylase and lipase is normal is very rare. This is a case of gall stone induced AP where levels of serum amylase and lipase are normal but the clinical suspicion and imaging are strongly confirming pancreatitis.

scholarly journals Follow-up survey of the prevalence, diagnosis, clinical manifestations and treatment of Spirocerca lupi in South Africa

2014 ◽  
Vol 85 (1) ◽  
Author(s):  
Remo Lobetti
Keyword(s):  
South Africa ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Clinical Findings ◽  
Seasonal Distribution ◽  
Diagnostic Methods ◽  
Post Mortem ◽  
Spirocerca Lupi ◽  
Important Disease

Spirocercosis is an important disease in South Africa. The object of this study was to determine if there had been a change in the prevalence, clinical manifestations and treatment of Spirocerca lupi over a 14-year period. A questionnaire was sent to 577 veterinary practices throughout South Africa in 2012. Of responders, 76% indicated that S. lupi occurred in their area, whilst 24% indicated that it did not; 84% considered S. lupi not to be a new phenomenon, whereas 16% considered it to be new. Monthly or seasonal distribution of the disease was not reported, and 76% of responders reported it to occur in no specific breed of dog, whereas 24% reported a breed risk, most considering large breeds to be at greater risk. No specific age or sex was identified as at higher risk. Common owner complaints were vomiting, weight loss, cough, or regurgitation. Reported clinical findings tended to mirror the clinical signs reported by owners. Most common diagnostic methods used were radiology, endoscopy, faecal flotation, and post mortem examination. Forty-four percent did not report seeing asymptomatic cases, 40% reported asymptomatic cases and 16% did not know. Associated complications were reported by 85% of responders, and included oesophageal neoplasia, hypertrophic osteopathy and acute haemothorax. Four different drugs were used as therapy: doramectin, ivermectin, milbemycin and Advocate®, with 9% of the responders using a combination of these four; 85% considered treatment to be effective and 15% ineffective. Treatment was considered more effective if the disease was diagnosed early and there were no complications. Two important conclusions were that more cases are being seen and that efficacy of therapy has increased, with a decrease in the mortality rate.

scholarly journals Toward Diagnosing Leishmania infantum Infection in Asymptomatic Dogs in an Area Where Leishmaniasis Is Endemic

2009 ◽  
Vol 16 (3) ◽  
pp. 337-343 ◽  
Author(s):  
D. Otranto ◽  
P. Paradies ◽  
D. de Caprariis ◽  
D. Stanneck ◽  
G. Testini ◽  
...  
Keyword(s):  
Leishmania Infantum ◽  
Clinical Signs ◽  
Antibody Test ◽  
Diagnostic Methods ◽  
Canine Leishmaniasis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Canine Monocytic Ehrlichiosis ◽  
Immunofluorescence Antibody Test ◽  
Immunofluorescence Antibody

ABSTRACT The most frequently used diagnostic methods were compared in a longitudinal survey with Leishmania infantum-infected asymptomatic dogs from an area of Italy where leishmaniasis is endemic. In February and March 2005, 845 asymptomatic dogs were tested by an immunofluorescence antibody test (IFAT), a dipstick assay (DS), and an enzyme-linked immunosorbent assay (ELISA) for L. infantum and by IFAT for Ehrlichia canis. Dogs seronegative for L. infantum were further parasitologically evaluated by microscopic examination of lymph node tissues and PCR of skin samples. A total of 204 animals both serologically and parasitologically negative for L. infantum at the first sampling were enrolled in the trial and were further examined for canine leishmaniasis (CanL) and canine monocytic ehrlichiosis in November 2005 (i.e., the end of the first sandfly season) and March 2006 and 2007 (1- and 2-year follow-ups, respectively). At the initial screening, the overall rates of L. infantum seroprevalence were 9.5% by IFAT, 17.1% by ELISA, and 9.8% by DS and the overall rate of E. canis seroprevalence was 15%. The rates of concordance between the results of IFAT and DS were almost equal, whereas the rate of concordance between the results of IFAT and DS and those of the ELISA was lower. The results of the annual incidence of Leishmania infection were variable, depending on the test employed, with the highest values registered for PCR (i.e., 5.7% and 11.4% at the 1- and 2-year follow-ups, respectively), followed by ELISA, IFAT, and DS. Over the 2 years of observation, 55 animals (i.e., 26.9%) became positive for L. infantum by one or more diagnostic tests at different follow-up times, with 12.7% showing clinical signs related to CanL, while the remaining 87.3% were asymptomatic. A diagnostic scheme for assessment of the L. infantum infection status in asymptomatic dogs is suggested.

Ancillary findings assessed by ventilation/perfusiont omography

2015 ◽  
Vol 54 (05) ◽  
pp. 223-230 ◽  
Author(s):  
A. Begic ◽  
E. Opankovic ◽  
V. Cukic ◽  
A. Lindqvist ◽  
M. Miniati ◽  
...  
Keyword(s):  
Heart Failure ◽  
Laboratory Tests ◽  
Clinical Suspicion ◽  
Left Heart ◽  
Left Heart Failure ◽  
Lung Tumours ◽  
High Prevalence ◽  
Clinical Consequences ◽  
Inflammatory State

SummaryVentilation/perfusion tomography (V/P SPECT) is a recommended method for diagnosing and follow-up of pulmonary embolism (PE). Moreover, it is possible to recognize other pathologies in addition to PE, such as pneumonia, COPD and left heart failure (LHF). The objective of this prospective study was to identify frequency of ancillary findings among patients with suspected PE. Patients, material, method: 331 consecutive patients with suspected PE were examined and classified with V/P SPECT. Patients were followed up clinically and by means of other laboratory tests. Results: 80 patients had a normal V/P SPECT and no clinical consequences in the follow-up. PE had 104 patients: 23 of them had also additional findings. Among the remaining 147 patients, pneumonias were shown in 82, acute in 75 patients and 7 had chronic post inflammatory state. COPD was present in 42 patients, in 3 combined with pneumonia. Sign of LHF was observed in 10: in 7 the acute LHF diagnosis was established, 3 were classified as having a chronic cardiopulmonary disease. Furthermore, in 16 patients, the V/P pattern was suggestive of a tumour. The clinical outcomes were 6 lung tumours, 3 empyema, one sarcoidosis, 2 were unclarified and 4 were lost in the follow-up. Conclusion: V/P SPECT identifies a high prevalence of other cardiopulmonary diseases among patients with a clinical suspicion of PE. Ancillary findings with V/P SPECT clarified patients' symptoms and had an impact on the treatment. These findings were verified by a clinical outcome by the follow-up over three months.

scholarly journals The Role of Routine Assays of Serum Amylase and Lipase for the Diagnosis of Acute Abdominal Pain

2009 ◽  
Vol 91 (5) ◽  
pp. 381-384 ◽  
Author(s):  
Paul A Sutton ◽  
David J Humes ◽  
Gemma Purcell ◽  
Janette K Smith ◽  
Frances Whiting ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Serum Amylase ◽  
Reference Range ◽  
Acute Abdominal Pain ◽  
Clinical Suspicion ◽  
University Teaching ◽  
Data Set ◽  
Serum Lipase

INTRODUCTION We aimed to evaluate the role of routine measurements of serum amylase and lipase in the diagnosis of acute abdominal pain. PATIENTS AND METHODS We identified all patients who had serum amylase and lipase assays over a 62-day period at a single university teaching hospital and reviewed their case notes. RESULTS We excluded 58 of the 1598 patients on grounds of ineligibility (< 18 years of age and those transferred from other hospitals). A complete data set was obtained for 1520 (98.7%) of the remaining 1540 patients. Only 9.1% of requests were based on a clinical suspicion of acute pancreatitis. Of the 44 (2.9%) patients who had acute pancreatitis, only 28 (63.6%) had an associated rise in serum amylase and/or lipase 3 times above the maximum reference range, the remainder being diagnosed radiologically. At this cut-off range, the sensitivity and specificity for serum amylase were 50% and 99%, and those for serum lipase 64% and 97%, respectively. CONCLUSIONS Routine measurements of serum amylase and lipase are unhelpful in the diagnosis of acute abdominal pain unless there is clinical suspicion of acute pancreatitis. In these patients, assay of lipase alone is preferable to assay of amylase alone or both enzymes.

scholarly journals Comparison of ultrasound and serum amylase in the diagnosis of acute pancreatitis

2020 ◽  
Vol 7 (12) ◽  
pp. 4030
Author(s):  
Manoharan G. V. ◽  
Maharaja P.
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Serum Amylase ◽  
Imaging Modality ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Amylase Level ◽  
Age Group ◽  
History Of ◽  
Clinical Signs And Symptoms

Background: Acute pancreatitis is an inflammatory disease of the pancreas. Though, severe acute pancreatitis constitutes 15-20% of all cases of pancreatitis, in recent times, mortality rate of severe acute pancreatitis has reduced from 30-80% to 15-20%. Ultrasound is the first imaging modality in most centres for the preliminary screening of an acute abdomen.Methods: In this prospective study between October 2017 to March 2019, 113 patients with clinical signs and symptoms of acute pancreatitis were screened with an ultrasonogram of the abdomen and serum amylase in the emergency room. Patients also underwent a complete physical exam.Results: In our study 38.9% of patients were in the age group of 45-55 years, 25% in the 35-45 age group and 20.4% in the 55 to 70 age group. 92.9% of the patients were men. 89.4% of the participants had a history of alcoholism. Only 37.2% of the participants who were clinically positive for acute pancreatitis, also showed USG findings for acute pancreatitis while 69% of the clinically positive patients showed serum amylase level positive for acute pancreatitis.Conclusions: Ultrasonogram though cheap and easily available is not ideal for the diagnosis of acute pancreatitis. As shown in the study serum amylase is able to detect nearly twice as many cases of pancreatitis compared to ultrasonogram. The sensitivity and specificity of ultrasonography to detect acute pancreatitis is too low to use as a diagnostic test but it is a valuable tool in the evaluation of an acute abdomen.

scholarly journals Fine needle aspiration cytology-based accurate and rapid diagnosis of breast tuberculosis masquerading as a case of abscess

2021 ◽  
Author(s):  
Vityala Yethindra ◽  
Altynai Zhumabekova ◽  
Cholpon Dzhumakova ◽  
Tugolbai Tagaev ◽  
Asel Namazbekova ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Diagnostic Method ◽  
Needle Aspiration ◽  
Rapid Diagnosis ◽  
Diagnostic Methods ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Breast Tuberculosis ◽  
Needle Aspiration Cytology

We are reporting a case of breast tuberculosis (BT) that was initially misdiagnosed as a breast abscess. Fine needle aspiration cytology (FNAC) helped in diagnosing BT faster by avoiding different invasive diagnostic methods. FNAC can be used as the primary diagnostic method of choice for the diagnosis of BT.

Post Discharge Clinically Overt Venous Thromboembolism in Orthopaedic Surgery Patients with Negative Venography -an Overview Analysis

1996 ◽  
Vol 76 (06) ◽  
pp. 0887-0892 ◽  
Author(s):  
Serena Ricotta ◽  
Alfonso lorio ◽  
Pasquale Parise ◽  
Giuseppe G Nenci ◽  
Giancarlo Agnelli
Keyword(s):  
Venous Thromboembolism ◽  
Orthopaedic Surgery ◽  
Diagnostic Methods ◽  
Future Research ◽  
Post Discharge ◽  
Pharmacological Prophylaxis ◽  
Vein Thrombosis ◽  
Overview Analysis ◽  
Major Orthopaedic Surgery

SummaryA high incidence of post-discharge venous thromboembolism in orthopaedic surgery patients has been recently reported drawing further attention to the unresolved issue of the optimal duration of the pharmacological prophylaxis. We performed an overview analysis in order to evaluate the incidence of late occurring clinically overt venous thromboembolism in major orthopaedic surgery patients discharged from the hospital with a negative venography and without further pharmacological prophylaxis. We selected the studies published from January 1974 to December 1995 on the prophylaxis of venous thromboembolism after major orthopaedic surgery fulfilling the following criteria: 1) adoption of pharmacological prophylaxis, 2) performing of a bilateral venography before discharge, 3) interruption of pharmacological prophylaxis at discharge in patients with negative venography, and 4) post-discharge follow-up of the patients for at least four weeks. Out of 31 identified studies, 13 fulfilled the overview criteria. The total number of evaluated patients was 4120. An adequate venography was obtained in 3469 patients (84.1%). In the 2361 patients with negative venography (68.1%), 30 episodes of symptomatic venous thromboembolism after hospital discharge were reported with a resulting cumulative incidence of 1.27% (95% C.I. 0.82-1.72) and a weighted mean incidence of 1.52% (95% C.I. 1.05-1.95). Six cases of pulmonary embolism were reported. Our overview showed a low incidence of clinically overt venous thromboembolism at follow-up in major orthopaedic surgery patients discharged with negative venography. Extending pharmacological prophylaxis in these patients does not appear to be justified. Venous thrombi leading to hospital re-admission are likely to be present but asymptomatic at the time of discharge. Future research should be directed toward improving the accuracy of non invasive diagnostic methods in order to replace venography in the screening of asymptomatic post-operative deep vein thrombosis.

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