PT  - JOURNAL ARTICLE
AU  - W R Matull
AU  - S P Pereira
AU  - J W O’Donohue
TI  - Biochemical markers of acute pancreatitis
AID  - 10.1136/jcp.2002.002923
DP  - 2006 Apr 01
TA  - Journal of Clinical Pathology
PG  - 340--344
VI  - 59
IP  - 4
4099  - http://jcp.bmj.com/content/59/4/340.short
4100  - http://jcp.bmj.com/content/59/4/340.full
SO  - J Clin Pathol2006 Apr 01; 59
AB  - 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.