Clinical value of rapid urine trypsinogen-2 test strip, urinary trypsinogen activation peptide, and serum and urinary activation peptide of carboxypeptidase B in acute pancreatitis

Sáez, J.; Martínez, Juan; Trigo, Celia; Sánchez‐Paya, José; Laveda, R; Griñó, P; Corchero, Cristina; Pérez‐Mateo, Miguel

doi:10.3748/wjg.v11.i46.7261

Cited by 39 publications

(30 citation statements)

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“…Plasma and urine levels of TAP have been found to be elevated and predictive of the development of acute pancreatitis [85,86] . However, this finding was not validated in other reports [87,88] . In a study looking specifically at post-ERCP patients, urinary TAP was not found to be useful in predicting mild PEP.…”

Section: Category 2: Markers Of Proteolytic Activationcontrasting

confidence: 53%

Pancreatits after endoscopic retrograde cholangio-pancreatography

Aziz

Lehman

2007

WJG

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Pancreatitis is the most common complication after endoscopic retrograde cholangio-pancreatography (ERCP); the reported incidence of this complication varies from less than 1% to 40%, but a rate of 4%-8% is reported in most prospective studies involving nonselected patients. Differences in criteria for defining pancreatitis, methods of data collection, and patient populations (i.e. number of high-risk patients included in the published series) are factors that are likely to affect the varying rates of post-ERCP pancreatitis. The severity of post-ERCP pancreatitis (PEP) can range from a minor inconvenience with one or two days of added hospitalization with full recovery to a devastating illness with pancreatic necrosis, multiorgan failure, permanent disability, and even death. Although, most episodes of PEP are mild (about 90%), a small percentage of patients (about 10%) develop moderate or severe pancreatitis. In the past, PEP was often viewed as an unpredictable and unavoidable complication, with no realistic strategy for its avoidance. New data have aided in stratification of patients into PEP risk categories and new measures have been introduced to decrease the risk of PEP. As most ERCPs are performed on an outpatient basis, the majority of patients will not develop PEP and can be discharged. Alternatively, early detection of those patients who will go on to develop PEP can guide decisions regarding hospital admission and aggressive management. In the last decade, great efforts have been addressed toward prevention of this complication. Points of emphasis have included technical measures, pharmacological prophylaxis, and patient selection. This review provides a comprehensive, evidence-based assessment of published data on PEP and current suggestions for its avoidance.© 2007 The WJG Press. All rights reserved.Key words: Endoscopic retrograde cholangiopancreatography; Post-ERCP pancreatitis Abdel Aziz AM, Lehman GA. Pacreatitis after endoscopic r e t r o g r a d e c h o l a n g i o -p a n c r e a t o g r a p h y . W o r l d J

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Section: Category 2: Markers Of Proteolytic Activationcontrasting

confidence: 53%

Pancreatits after endoscopic retrograde cholangio-pancreatography

Aziz

Lehman

2007

WJG

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“…Gallstones were the most common causes of AP (n = 58, 63%), while familial Mediterranean fever and acute appendicitis were the most common causes of acute abdominal pain in patients in the control group (n = 5, 20% and n = 5, 20%, respectively) ( Table 1). Mean BMI of patients in the study and control groups were 24.0 ± 3.8 kg/m 2 (range, 16-33) and 23.5 ± 3.4 kg/m 2 (range, [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], respectively (P = 0.902). Both mean serum amylase concentrations and mean serum lipase concentrations were significantly higher in patients in the study group compared with those in the control [amylase, 600.8 ± 189.7 U/L (range, 376-1250) vs 67 ± 32.5 U/L (range, 18-176), and lipase, 96.2 ± 42.4 U/L (range, 58-230) vs 33.8 ± 15 U/L (range, 13-65); P = 0.000)].…”

Section: Resultsmentioning

confidence: 99%

“…Kemppainen et al 1997 [29] 94 95 Kylanpaa-Back et al 2000 [28] 96 92 Lempinen et al 2001 [5] 62 87 Pezzilli et al 2001 [27] 53.3 -Lempinen et al 2003 [7] 72 81 Chen et al 2005 [16] 89.6 85.7 Saes et al 2005 [30] 68 86. mild abdominal discomfort to multiple organ failure. After a mild pancreatitis attack, 80% of patients recover completely, while the disease worsens in 20% and has a mortality rate of 30% [1,[17][18][19] .…”

Section: Ap Presents In Various Clinical For Ms Ranging Frommentioning

confidence: 99%

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Early diagnosis and prediction of severity in acute pancreatitis using the urine trypsinogen-2 dipstick test: A prospective study

Erdinc¹,

Kamer²,

Haluk³

et al. 2007

WJG

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AIM:To evaluate the use of the trypsinogen-2 dipstick (Actim Pancreatitis) test for early diagnosis and prediction of severity in acute pancreatitis (AP). METHODS:Ninety-two patients with AP were included in this study. The control group was 25 patients who had acute abdominal pain from non-pancreatic causes. Urine trypsinogen-2 dipstick test (UTDT) and conventional diagnostic tests were performed in all patients. Patients were divided by the Atlanta classification into two groups as having mild or severe pancreatitis. RESULTS:UTDT was positive in 87 (94.6%) of the AP patients and in two (8%) controls (P < 0.05). Positive UTDT was found in 61 (92.4%) of 66 (71.7%) patients with mild pancreatitis and in all (100%) of the 26 (28.3%) with severe pancreatitis (P > 0.05). UTDT positivity lasted longer in severe pancreatitis compared with that in mild pancreatitis (6.2 ± 2.5 d vs 2.0 ± 1.43 d, P < 0.05).The sensitivity, specificity, positive predictive value, negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of UTDT were 91%, 72%, 96.6%, 70.4%, 3.4 and 0.1, respectively. CONCLUSION:UTDT is a simple, rapid and reliable method for use on admission. It has high specificity and low NLR for early diagnosis and prediction of severity in AP. However, its relatively low NPV does not allow trypsinogen-2 dipstick test to be a stand-alone tool for diagnosis of acute pancreatitis; the use of other conventional diagnostic tools remains a requirement.

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“…Some studies have advocated the use of urinary trypsinogen-2 as a screening tool, with a positive result indicating a need for further evaluation of acute pancreatitis. [18][19][20] Urinary trypsinogen-2 is less costly than serum tests, plus may result in additional cost savings with earlier patient discharge. Unfortunately, this test is not widely available for clinical use.…”

Section: Etiologymentioning

confidence: 99%

Acute pancreatitis

Munsell

Buscaglia

2010

Journal of Hospital Medicine

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Acute pancreatitis is a common disease most frequently caused by gallstone disease or excess alcohol ingestion. Diagnosis is usually based on characteristic symptoms, often in conjunction with elevated serum pancreatic enzymes. Imaging is not always necessary, but may be performed for many reasons, such as to confirm a diagnosis of pancreatitis, rule out other causes of abdominal pain, elucidate the cause of pancreatitis, or to evaluate for complications such as necrosis or pseudocysts. Though the majority of patients will have mild, self‐limiting disease, some will develop severe disease associated with organ failure. These patients are at risk to develop complications from ongoing pancreatic inflammation such as pancreatic necrosis, fluid collections, pseudocysts, and pancreatic duct disruption. Validated scoring systems can help predict the severity of pancreatitis, and thus, guide monitoring and intervention.Treatment of acute pancreatitis involves supportive care with fluid replacement, pain control, and controlled initiation of regular food intake. Prophylactic antibiotics are not recommended in acute pancreatitis if there is no evidence of pancreatic infection. In patients who fail to improve, further evaluation is necessary to assess for complications that require intervention such as pseudocysts or pancreatic necrosis. Endoscopy, including ERCP and EUS, and/or cholecystectomy may be indicated in the appropriate clinical setting. Ultimately, the management of the patient with severe acute pancreatitis will require a multidisciplinary approach. Journal of Hospital Medicine 2010;5:241–250. © 2010 Society of Hospital Medicine.

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Clinical value of rapid urine trypsinogen-2 test strip, urinary trypsinogen activation peptide, and serum and urinary activation peptide of carboxypeptidase B in acute pancreatitis

Cited by 39 publications

References 19 publications

Pancreatits after endoscopic retrograde cholangio-pancreatography

Pancreatits after endoscopic retrograde cholangio-pancreatography

Early diagnosis and prediction of severity in acute pancreatitis using the urine trypsinogen-2 dipstick test: A prospective study

Acute pancreatitis

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