Biochemical markers of acute pancreatitis.
Serum amylase remains the most commonly used biochemical marker for the diagnosis of acute pancreatitis, but its sensitivity can be reduced by late presentation, hypertriglyceridaemia, and chronic alcoholism. Urinary trypsinogen-2 is convenient, of comparable diagnostic accuracy, and provides greater (99%) negative predictive value. Early prediction of the severity of acute pancreatitis can be made by well validated scoring systems at 48 hours, but the novel serum markers procalcitonin and interleukin 6 allow earlier prediction (12 to 24 hours after admission). Serum alanine transaminase >150 IU/l and jaundice suggest a gallstone aetiology, requiring endoscopic retrograde cholangiopancreatography. For obscure aetiologies, serum calcium and triglycerides should be measured. Genetic polymorphisms may play an important role in "idiopathic" acute recurrent pancreatitis.
Matull
W R
WR
Institute of Hepatology, University College London Medical School, London, UK.
Pereira
S P
SP
O'Donohue
J W
JW
D000208:Acute Disease; D000410:Alanine Transaminase / Q000097:blood; D000681:Amylases / Q000097:blood; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007527:Isoenzymes / Q000652:urine; D008049:Lipase / Q000097:blood; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D011498:Protein Precursors / Q000097:blood; D012680:Sensitivity and Specificity; D013997:Time Factors; D014362:Trypsinogen / Q000652:urine
D015415:Biomarkers; C000606589:CALCA protein, human; D015850:Interleukin-6; D007527:Isoenzymes; D011498:Protein Precursors; D014362:Trypsinogen; D002116:Calcitonin; D000410:Alanine Transaminase; D008049:Lipase; D000681:Amylases; D015740:Calcitonin Gene-Related Peptide