Plasma values of immunoreactive interleukin-6, C-reactive protein and phospholipase A have been determined in serial samples from 24 patients with acute pancreatitis ('mild' pancreatitis nine, 'severe' pancreatitis 15). Median plasma concentrations of interleukin-6, C-reactive protein, and phospholipase A activity were significantly higher in patients with 'severe' illness (p<0.001) than those with 'mild' illness. A particularly marked increase in interleukin-6 was found in two patients with necrotising pancreatitis and fatal outcome. Significant correlations between plasma concentrations of interleukin-6 and phospholipase A (p=0.0218) and C-reactive protein and phospholipase A activity (p<0.0001) were found in patients with 'severe' disease. These findings in a limited number of patients with acute pancreatitis are promising in that raised interleukin-6 correlated with clinical severity and with two other established markers, Creactive protein, and phospholipase A activity.

The role of the inflammatory response in acute pancreatitis and its relation with the clinical course was examined. This study examined if the serial measurement of polymorphonuclear granulocyte (PMN) elastase/AlPI complex, phospholipase A catalytic activity, C reactive protein, and other acute phase proteins, and the protease inhibitor a2-macroglobulin, provides meaningful information for prognosis.Eighty non-consecutive patients with acute pancreatitis, classified according to their clinical outcome into mild (n=40) and severe pancreatitis (n=40), were followed up daily. Between 48 hours, median values of PMN-elastase, C reactive protein -and most of the acute phase proteins -and phospholipase A activity, were significantly higher in the severe pancreatitis group. PMN elastase shows a dynamic course and it reaches an early peak value at days 1-2, followed by C reactive protein (days 2-4) phospholipase A (day 3), and a negative peak for cx2-macroglobulin (days [4][5] Descriptive and explorative data analysis was made for all variables (days 1-5). By using the data obtained within 48 hours of admission, we applied discriminant function analysis to predict severity in acute pancreatitis. Methods PATIENTSWe studied a group of 80 non-consecutive patients, 43 men and 37 women with a median age of 58 years (range 23-89). The diagnosis of acute pancreatitis was based on typical clinical symptoms and at least a twofold increase of specific pancreatic serum enzymes (pancreatic amylase or lipase). Further

No abstract

No abstract