Evaluation of pancreatic amylase immunoassay in acute pancreatitis

Sacchetti, Lucia; Cavalcanti, Ernesta; Cerasuolo, Dionigio; Oriani, G.; Uomo, Generoso; Rabitti, Pier Giorgio; Laccetti, M; Visconti, M; Salvatore, Francesco

doi:10.1016/0009-8981(89)90279-9

Cited by 9 publications

(2 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, another study using independent criteria to classify the study subjects found similar specificity of the pancreatic isoenzyme and total amylase measurements (22). Several other studies have examined the isoenzyme content of specimens from patients chosen for study because of an elevated total amylase activity, and all concluded that pancreatic amylase determinations were helpful in excluding false-positive amylase elevations due to nonpancreatic disease (23)(24)(25)(26)(27)(28)(29).…”

Section: Discussionmentioning

confidence: 99%

Rapid measurement of serum pancreatic amylase

Landt

Hortin

Smith

et al. 1994

Clinical Laboratory Analysis

View full text Add to dashboard Cite

A simple, rapid assay for the pancreatic isoenzyme of human serum amylase was developed. The assay utilized an immunoabsorbent prepared by coating latex beads with a monoclonal antibody specific for pancreatic amylase. Treatment of patient serum with immunoabsorbent removed pancreatic amylase, and measurement of residual amylase activity with standard total amylase methodology allowed estimation of the pancreatic amylase content. Extraction efficiency of pancreatic amylase was consistent at amylase concentrations up to 1,000 U/L (y = 0.97 x +16.7 U/L; r = 0.9995). The assay was standardized with purified pancreatic amylase added to neonatal serum (low endogenous activity). A comparison of patient specimen results with the results of a standard technique (cellulose acetate electrophoresis) yielded an excellent correlation (immunoabsorption result = 0.96 electrophoresis result + 1.2 U/L; r = 0.987). Salivary amylase did not interfere with the assay until levels exceeded 1,000 U/L. Daily analysis of a frozen serum pool yielded a coefficient of variation of 9.2% at mean pancreatic amylase value of 54 U/L (+/- 5 U/L). A normal range study found a strong influence of age, with pancreatic amylase levels increasing dramatically in the first 3 years of life, to stabilize at a range of 0-66 U/L thereafter.

show abstract

Section: Discussionmentioning

confidence: 99%

Rapid measurement of serum pancreatic amylase

Landt

Hortin

Smith

et al. 1994

Clinical Laboratory Analysis

View full text Add to dashboard Cite

show abstract

“…Determination of serum levels of lipase, trypsin and elastase overcome the need for deter mination of urinary amylase and amylase to creatinine clearance ratio, as they remain high for several days after the onset of the disease [15], Episodes of AP with serum enzymes levels below their cutoffs may also be seen in patients with alcoholic disease, in whom the pancreas is chronically inflamed and largely replaced by fibrotic tissue [16]. Figure 2 summarizes the data on the sensitivity of different pancreatic enzymes in the diagnosis of AP [ 14,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31].…”

Section: Diagnostic Sensitivitymentioning

confidence: 99%

Diagnosis and Staging of Acute Pancreatitis

Malfertheiner¹,

Domínguez‐Muñoz²

1994

Dig Surg

View full text Add to dashboard Cite

Determination of serum pancreatic enzymes remains the gold standard for the diagnosis of acute pancreatitis. Clinical symptoms and signs are of major importance in suspecting the disease, but they are not accurate enough to confirm the diagnosis. The different serum pancreatic enzymes have a similar accuracy in the diagnosis of acute pancreatitis. Total amylase, pancreatic isoamylase and lipase are preferred, since simple, rapid and inexpensive enzymatic methods are commercially available. More expensive and cumbersome methods (e.g. RIA or ELISA for pancreatic elastase) are useful only in special clinical circumstances. For early etiological classification of acute pancreatitis serum pancreatic enzymes and even different enzyme ratios are not reliable. For this purpose, determination of AST, bilirubin and alkaline phosphatase may make it possible to distinguish between biliary and nonbiliary origin of the disease. Ultrasonography and computed tomography provide very valuable information regarding not only etiology but also local complications of acute pancreatitis. Once the diagnosis of acute pancreatitis has been established, prognostic classification of the disease is required for adequate monitoring and treatment. Clinical symptoms and signs do not allow early assessment of the prognosis of acute pancreatitis. Multivariate scoring systems are sensitive but not sufficiently specific for the identification of severe pancreatitis. Among several biochemical markers commercially available for the assessment of severity, C-reactive protein and PMN-elastase appear to be the most valuable. These markers allow a proper selection of patients who need further investigation by contrast-enhanced CT (the gold standard for detection of pancreatic necrosis).

show abstract

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

View full text Add to dashboard Cite

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.

show abstract

Evaluation of pancreatic amylase immunoassay in acute pancreatitis

Cited by 9 publications

References 8 publications

Rapid measurement of serum pancreatic amylase

Rapid measurement of serum pancreatic amylase

Diagnosis and Staging of Acute Pancreatitis

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

Contact Info

Product

Resources

About