Related Experiment Videos
Serum pancreatic enzyme behavior during the course of acute pancreatitis
M Ventrucci1, R Pezzilli, P Naldoni
1Institute of Medicine and Gastroenterology, University of Bologna, Italy.
Insights
Serum enzyme levels like amylase and lipase are elevated in acute pancreatitis. Elastase 1 is the most sensitive marker for pancreatic damage in later disease stages.
Area of Science:
- Biochemistry
- Gastroenterology
- Clinical Diagnostics
Background:
- Acute pancreatitis is a serious condition characterized by inflammation of the pancreas.
- Accurate and timely diagnosis is crucial for effective patient management and improved outcomes.
- Monitoring serum enzyme levels aids in diagnosing and assessing the severity of acute pancreatitis.
Purpose of the Study:
- To evaluate the dynamic changes in serum levels of amylase, pancreatic isoamylase, lipase, trypsinogen, and elastase 1 in patients with acute pancreatitis.
- To determine the diagnostic efficiency of these enzymes in the early stages of acute pancreatitis.
- To identify the most sensitive enzyme marker for detecting pancreatic damage in later stages of the disease.
Main Methods:
- Serum samples were collected from 21 patients diagnosed with acute pancreatitis.
- Enzyme levels (amylase, pancreatic isoamylase, lipase, trypsinogen, elastase 1) were measured daily for a mean of 7 days post-admission.
- Variations in enzyme levels were analyzed in relation to the onset of acute pancreatitis and disease progression.
Main Results:
- All evaluated enzyme levels were significantly elevated on the day of acute pancreatitis onset.
- Pancreatic isoamylase showed the highest relative increase, while elastase 1 had the lowest.
- After the initial rise, most enzyme levels decreased in parallel, except for elastase 1.
- By day 8, elastase 1 remained elevated in all patients, indicating sustained pancreatic damage.
Conclusions:
- Amylase, pancreatic isoamylase, lipase, and trypsinogen are equally effective for the early diagnosis of acute pancreatitis.
- Elastase 1 emerges as the most sensitive biomarker for detecting pancreatic damage in the later stages of acute pancreatitis.
- Monitoring elastase 1 levels can provide valuable insights into the progression and severity of acute pancreatitis.
Abstract:
The variations of serum levels of amylase, pancreatic isoamylase, lipase, trypsinogen, and elastase 1 were evaluated in 21 patients with acute pancreatitis. The patients were studied for a mean period of 7 consecutive days (range 5-12 days) after admission to the hospital. On the day of onset of acute pancreatitis, all enzyme levels were abnormally high; pancreatic isoamylase showed the greatest increase compared with its upper normal limit, whereas the increase increment for elastase 1 was the lowest. Subsequently, all enzyme levels except elastase 1 decreased in a parallel fashion. On the eighth day of the study only elastase 1 levels were above normal values in all patients examined, while abnormally high values of lipase were found in 85% of the patients, trypsinogen in 58% of the patients, pancreatic isoamylase in 43%, and total amylase in 23%. These results indicate that, for the early diagnosis of acute pancreatitis, the determination of any of these enzymes is equally efficient, but that elastase 1 is the most sensitive marker of acute pancreatic damage in later stages of the disease.