Significance of serum endotoxin and antiendotoxin antibody levels in predicting the severity of acute pancreatitis.
OBJECTIVE
A close association between endotoxemia and acute pancreatitis has been reported, and attempts have been made to predict the severity of pancreatitis by estimating the levels of endotoxin. The present study was designed to correlate endotoxemia with the severity and complications of acute pancreatitis as graded by contrast-enhanced computed tomography and Blamey's criteria.


METHODS
We examined 20 patients with acute pancreatitis, using Blamey's criteria to assess the severity of pancreatitis. The endotoxin level was estimated by the Limulus Amoebocyte Lysate method and the antiendotoxin antibody level was assayed by the enzyme-linked immunoassay technique measuring combined levels of IgG and IgM.


RESULTS
Severe pancreatitis was confirmed in 9 of the 20 patients, 17 (85%) of whom were found to have endotoxemia. There was no correlation between the presence and level of endotoxemia and the severity of pancreatitis; however, antiendotoxin antibody titers were significantly lower in patients with severe disease ( P < 0.05), those who suffered of major complications ( P < 0.01), and those who died of the disease ( P < 0.01).


CONCLUSIONS
The findings of this study demonstrated that the presence of endotoxemia accompanied by a fall in antiendotoxin antibody titer predicts poor outcome in patients with acute pancreatitis.
Department of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Shashanka Mohan
SM
Bose
Ganga Ram
GR
Verma
Alok
A
Mazumdar
M
M
Giridhar
Nirmal Kumar
NK
Ganguly
D000208:Acute Disease; D000328:Adult; D019446:Endotoxemia / Q000145:classification / Q000150:complications*; D004731:Endotoxins / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D016019:Survival Analysis
D004731:Endotoxins; D007074:Immunoglobulin G; D007075:Immunoglobulin M