Trypsinogen activation peptides assay in the early prediction of severity of acute pancreatitis

Gudgeon, A. M.; Heath, Dugal; Hurley, Paul R.; Jehanli, Ahmed; Patel, Geeta; Wilson, C; Shenkin, Alan; Austen, Brian; Imrie, C. W.; Hermon‐Taylor, John

doi:10.1016/0140-6736(90)90135-r

Cited by 250 publications

(114 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: 52%

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: 52%

Pancreatits after endoscopic retrograde cholangio-pancreatography

Aziz

Lehman

2007

WJG

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“…Although the concentration of trypsinogen-2 in urine may be influenced by dehydration and impaired renal function, such effects are likely to be small in the early stages of pancreatitis 12 . In spite of this potential limitation, trypsinogen-2 in urine showed good accuracy for evaluation of the severity of the disease.…”

Section: Resultsmentioning

confidence: 99%

Frequency of Raised Urinary Trypsinogen-2 in Acute Pancreatitis

Ali¹,

Mehsam²,

Hussain³

et al. 2017

Int. j. endorsing health sci. res.

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Objectives To determine the frequency of raised Urinary Trypsinogen-2 in diagnosed patients of acute pancreatitis. Methodology Settings Patients in emergency refer to General Surgery ward-3 Jinnah Post Graduate and Medical Centre Karachi. Duration Six months, started from 20-01-2012 to 19-07-2012. Study Design Cross sectional descriptive study. Subjects and Methods All cases of Acute Pancreatitis diagnosed by Upper Abdominal Pain, Raised Serum Amylase and/or Serum Lipase and Abdominal CT Scan findings, were included in the study. Urinary Trypsinogen-2 dipstick test was done. All patient related data including age, gender, sex and raised Urinary Trypsinogen-2 or normal, was recorded. Data analysis was done on SPSS version 10. Frequency and percentage was calculated for gender and raised trypsinogen-2. Age and gender wise stratification was done to see the effect of these variables on outcome. Results Mean age of the patients was 38.14 ±7.42 years. The minimum age was 24 years, while the maximum age was 63 years. Raised urinary trypsinogen-2 level was present in 55 (65.5%) patients. Stratification of age group shows, that 40 (66.7%) patients in age group ≤ 40 years had raised urinary trypsinogen-2. Stratification of gender showed significant association with raised urinary trypsinogen-2 level (p-value 0.010). Conclusion The frequency of raised Urinary Trypsinogen-2 in diagnosed patients of acute pancreatitis was found to be high.

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“…The activation peptides of trypsinogen and carboxypeptidase A 1 (CPA 1 ), which are cleaved from the respective proenzyme during the process of activation, are released into the pancreatic tissue or the serum early in the course of acute pancreatitis [20,[23][24][25][26][27].…”

Section: The Mechanism and Intracellular Site Of Zymogen Activationmentioning

confidence: 99%