[Lipase/amylase ratio in biliary acute pancreatitis and alcoholic acute/acutized chronic pancreatitis].
BACKGROUND
Alcoholic or biliary acute pancreatitis may need different therapeutic approaches.


OBJECTIVE
Assessing the validity of lipase/amylase ratio in differentiating biliary from alcoholic acute pancreatitis/acutized chronic pancreatitis.


METHODS
Nine male patients (mean age and standard deviation: 39.8 +/- 7.0 years) with alcoholic acute pancreatitis/acutized chronic pancreatitis (group I) and 29 patients, 8 male and 21 female (mean age: 43.6 +/-19.9 years), with biliary acute pancreatitis (group II) were evaluated. Serum lipase and amylase levels were measured in patients with symptoms for no more than 48 hours. The lipase/amylase ratio was calculated based on serum lipase and amylase levels and expressed as multiples of their respective superior reference values.


RESULTS
Mean levels of serum lipase (4,814 +/- 3,670 U/L) and amylase (1,282 +/- 777 U/L) in patients of group I were comparable to group II (2,697 +/- 2,391 and 1,878 +/- 1,319 U/L, respectively), but the mean lipase/amylase ratio was significantly higher in group I (4.4 +/- 3.6) than in group II (2.2 +/- 2.2). Lipase/amylase ratio >3 occurred at significantly higher proportions in patients of group I (66.7%) than of group II (24.1%), differentiating the two groups with sensitivity of 67% and specificity of 76%.


CONCLUSIONS
1) Amylase and lipase serum levels did not differ in the two groups evaluated; 2) the lipase/amylase ratio >3 was more often seen in alcoholic acute pancreatitis/acutized chronic pancreatitis than biliary acute pancreatitis, and it may be useful in differentiating these two causes of pancreatitis.
Pacheco
Ricardo Custódio
RC
Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG.
Oliveira
Luiz Carlos Marques de
LC
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood*; D001660:Biliary Tract Diseases / Q000150:complications*; D004796:Clinical Enzyme Tests; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology; D019512:Pancreatitis, Alcoholic / Q000175:diagnosis / Q000201:enzymology; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000201:enzymology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
D008049:Lipase; D000681:Amylases