A Cause of Misleading Serum Amylase Concentrations in Acute Pancreatitis

La, Donaldson; McIntosh, W. B.

doi:10.1177/003693307702200212

Cited by 4 publications

References 8 publications

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Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis

Rompianesi

Hann

Komolafe

et al. 2017

Cochrane Database of Systematic Reviews

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As about a quarter of people with acute pancreatitis fail to be diagnosed as having acute pancreatitis with the evaluated tests, one should have a low threshold to admit the patient and treat them for acute pancreatitis if the symptoms are suggestive of acute pancreatitis, even if these tests are normal. About 1 in 10 patients without acute pancreatitis may be wrongly diagnosed as having acute pancreatitis with these tests, therefore it is important to consider other conditions that require urgent surgical intervention, such as perforated viscus, even if these tests are abnormal.The diagnostic performance of these tests decreases even further with the progression of time, and one should have an even lower threshold to perform additional investigations if the symptoms are suggestive of acute pancreatitis.

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Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis

Rompianesi

Hann

Komolafe

et al. 2017

Cochrane Database of Systematic Reviews

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Hyperlipidaemia, alcohol abuse and acute pancreatitis

Dickson

Neill

Imrie

1984

Journal of British Surgery

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Of 311 patients with primary acute pancreatitis, seven revealed major and seven minor lipid abnormalities on hospital admission. One pregnant woman suffered acute pancreatitis associated with Fredrickson type I hyperlipoproteinaemia. Twelve of the 13 men with types IV and V hyperlipoproteinaemia suffered alcohol abuse pancreatitis and represented 13.2 per cent of this aetiological group. However, only one of the 157 patients (0.6 per cent) with biliary disease had lipid abnormalities. Two of the 13 men died--the oldest, who had gallstones, and one with alcohol related disease. The remaining 11 were subject to follow-up (5-10 years). Six, who had improvement of their lipid abnormalities, had abstained from alcohol. The other five had a persistent lipid disorder, and all admitted continuing heavy alcohol ingestion. The clinical diagnosis of acute pancreatitis was supported by serum amylase elevation in only nine of the fourteen patients. Urinary amylase levels were consistent with the diagnosis in 11 of the 12 patients. Estimation of both serum and urinary amylase gave 100 per cent support to the clinical diagnosis of acute pancreatitis. Hyperlipidaemia associated with acute pancreatitis may be secondary to alcohol abuse but the possible role of HLP cannot be discounted. Urinary amylase is useful in diagnosing acute pancreatitis in the presence of hyperlipidaemia.

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Acute Pancreatitis

Joffe¹,

Donaldson²

1983

Care of the Critically Ill Patient

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A Cause of Misleading Serum Amylase Concentrations in Acute Pancreatitis

Cited by 4 publications

References 8 publications

Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis

Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis

Hyperlipidaemia, alcohol abuse and acute pancreatitis

Acute Pancreatitis

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