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Evaluating the Role of Urinary Amylase in Diagnosing Acute Pancreatitis: A Systematic Review and Meta-Analysis
Cathleen A McCarrick1, Ashokkumar Singaravelu1, Ahmed Al Rasheed2
1Surgery, University College Dublin, Dublin, IRL.
Abstract:
Acute pancreatitis is a life-threatening and increasingly common condition. Although serum amylase and lipase are established diagnostic markers, the clinical relevance of urinary amylase is still uncertain. This systematic review and meta-analysis aimed to assess the diagnostic accuracy of urinary amylase in adults with suspected acute pancreatitis. We registered our review with PROSPERO (CRD42024528325) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. We systematically searched PubMed, EMBASE, Ovid Medline, Scopus, the Cochrane Library, and Web of Science for studies of adult patients with acute abdominal pain who had quantitative urinary amylase measurements performed. Two reviewers independently screened articles for inclusion and extracted data from eligible studies. The risk of bias and applicability of the included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Our search identified 178 studies, of which eight met the inclusion criteria; three cross-sectional studies and two case-control studies were included in the meta-analysis. Urinary amylase had a sensitivity of 0.80 (95% confidence interval (CI): 0.65-0.89) and specificity of 0.86 (95% CI: 0.76-0.93) at a model-derived optimal threshold of 1,373 IU/L. Our results indicate that urinary amylase does not appear to outperform serum amylase, and its suggested utility in delayed or atypical presentations of acute pancreatitis remains unsubstantiated.
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Acute Pancreatitis II: Clinical Manifestations and Management
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Assessment:
Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
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When acidic chyme from the stomach enters the duodenum, it triggers the release of secretin, a hormone that prompts pancreatic juice secretion. After a fatty meal, cholecystokinin, another hormone, stimulates gallbladder contraction and enhances enzyme-rich...
Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Urine Studies I: Urinalysis