Correlation between Serum Concentrations of Three Specific Exocrine Pancreatic Proteins and Pancreatic Duct Morphology at ERCP Examinations

Borgström, Anders; Wehlin, L

doi:10.1080/00365521.1984.12005713

Cited by 48 publications

(8 citation statements)

References 21 publications

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“…The good correlation between serum levels of amylase and trypsinogen seen in earlier works [8] was also confirmed. The presence of trypsin-ulPI complexes alone in serum does not, however, seem to be specific for acute pancreatitis.…”

Section: Discussionsupporting

confidence: 76%

Patterns of immunoreactive trypsin in serum from patients with acute abdominal disorders

Borgström

Lasson

Ohlsson

1989

Scandinavian Journal of Clinical and Laboratory Investigation

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Immunoreactive trypsin in serum can be divided into trypsinogen and trypsin-alpha 1-proteinase inhibitor (alpha 1PI) complexes. These were studied separately in serum from 204 patients with acute gastro-intestinal symptoms. Elevated levels of both trypsinogen and trypsin-alpha 1PI complexes were seen in patients with acute pancreatitis. Elevated levels of trypsinogen and normal or slightly elevated levels of trypsin-alpha 1PI complexes were seen in patients with biliary tract diseases. An isolated increase in the concentration of trypsin-alpha 1PI complexes with normal trypsinogen and amylase levels were seen in patients with perforated ulcer. This third cluster may result from an absorption of active trypsin from the peritoneal cavity. Small amounts of trypsin-alpha 1PI complexes were present also in serum from patients free from pancreatic disease. The results in this study show that high levels of trypsin-alpha 1PI complexes in serum are seen mainly in patients with acute pancreatitis. However, elevated levels are also seen in other pathological conditions in the upper gastrointestinal tract; therefore an assay for these complexes is not a specific diagnostic test for acute pancreatitis.

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Section: Discussionsupporting

confidence: 76%

Patterns of immunoreactive trypsin in serum from patients with acute abdominal disorders

Borgström

Lasson

Ohlsson

1989

Scandinavian Journal of Clinical and Laboratory Investigation

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“…Borgstrom and Wehlin have reported a deficiency of pancreatic amylase activity in plasma in two women with a normal trypsin activity and normal endoscopic retrograde pancreatography. 16 Familial occurrence of selectively diminished pancreatic serum amylase activity has recently been reported by Brock et al'7 and Jorgensen et al'8 Unfortunately, they did not measure lipolytic enzymes in serum or pancreatic enzyme activity in duodenal aspirate. We report two cases of documented specific and probably congenital pancreatic amylase deficiency.…”

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confidence: 93%

Selective deficiency of pancreatic amylase.

Sjölund

Häggmark²,

Ihse³

et al. 1991

Gut

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Two patients with specific pancreatic amylase deficiency are described. The greatly reduced pancreatic amylase activity was not due to an enzymatically inactive amylase molecule but to an almost complete absence of the molecule itself. The findings are of diagnostic importance as they show that low pancreatic amylase activity in serum or duodenal aspirates, or both, does not necessarily represent chronic exocrine pancreatic disease such as chronic pancreatitis, carcinoma of the pancreas, or cystic fibrosis but may be an isolated finding. In one ofour patients a familial occurrence was shown, indicating a congenital deficiency.

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“…5 14Therefore, measurement of serum or urine amylase often results in a groundless suspicion of pancreatitis. Hence there is a need for a more specific and accurate method for diagnosing and estimating the severity of pancreatic damage during the first few hours after ERCP.…”

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confidence: 99%

Increased serum trypsinogen 2 and trypsin 2-α₁antitrypsin complex values identify endoscopic retrograde cholangiopancreatography induced pancreatitis with high accuracy

Kemppainen

Hedström

Puolakkainen

et al. 1997

Gut

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Aims-To evaluate the clinical utility of two new tests for serum trypsinogen 2 and trypsin 2-1 antitrypsin complex (trypsin 2-AAT) in diagnosing and assessing the severity of acute pancreatitis (AP) induced by endoscopic retrograde cholangiopancreatography (ERCP). Patients-Three hundred and eight consecutive patients undergoing ERCP at Helsinki University Central Hospital in 1994 and 1995. Methods-Patients were followed prospectively for pancreatitis and clinical outcome. They were tested for serum trypsinogen 2, trypsin 2-AAT, and amylase in samples obtained before and one, six, and 24 hours after ERCP. Results-Pancreatitis developed in 31 patients (10%). Their median serum trypsinogen 2 increased 26-fold to 1401 µg/l at six hours after the procedure and trypsin 2-AAT showed an 11-fold increase to 88 µg/l at 24 hours. The increase in both markers was stronger in severe than in mild pancreatitis, and in patients without pancreatitis there was no significant increase. Baseline trypsinogen 2 and trypsin 2-AAT concentrations were elevated in 29% and 32% of patients, respectively. The diagnostic accuracy of a threefold elevation over the baseline value was therefore analysed. The sensitivity and specificity of these parameters in the diagnosis of post-ERCP pancreatitis was 93% and 91%, respectively, for serum trypsinogen 2 at six hours after the examination, and 93% and 90%, for trypsin 2-AAT at 24 hours. Conclusions-Serum trypsinogen 2 and trypsin 2-AAT reflect pancreatic injury after ERCP. High concentrations are associated with severe pancreatic damage. The delayed increase in trypsin 2-AAT compared with trypsinogen 2 appears to reflect the pathophysiology of AP. A greater than threefold increase in trypsinogen 2 six hours after ERCP is an accurate indicator of pancreatitis. (Gut 1997; 41: 690-695)

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Correlation between Serum Concentrations of Three Specific Exocrine Pancreatic Proteins and Pancreatic Duct Morphology at ERCP Examinations

Cited by 48 publications

References 21 publications

Patterns of immunoreactive trypsin in serum from patients with acute abdominal disorders

Patterns of immunoreactive trypsin in serum from patients with acute abdominal disorders

Selective deficiency of pancreatic amylase.

Increased serum trypsinogen 2 and trypsin 2-α₁antitrypsin complex values identify endoscopic retrograde cholangiopancreatography induced pancreatitis with high accuracy

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Correlation between Serum Concentrations of Three Specific Exocrine Pancreatic Proteins and Pancreatic Duct Morphology at ERCP Examinations

Cited by 48 publications

References 21 publications

Patterns of immunoreactive trypsin in serum from patients with acute abdominal disorders

Patterns of immunoreactive trypsin in serum from patients with acute abdominal disorders

Selective deficiency of pancreatic amylase.

Increased serum trypsinogen 2 and trypsin 2-α1antitrypsin complex values identify endoscopic retrograde cholangiopancreatography induced pancreatitis with high accuracy

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Product

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Increased serum trypsinogen 2 and trypsin 2-α₁antitrypsin complex values identify endoscopic retrograde cholangiopancreatography induced pancreatitis with high accuracy