Serum elastase 1 in inflammatory pancreatic and gastrointestinal diseases and in renal insufficiency. A comparison with other serum pancreatic enzymes |
| |
Institution: | (1) Department of Internal Medicine, University of Ulm, Ulm, F.R.G.;(2) Gastroenterology Unit, Mayo Clinic, 55905 Rochester, MN, U.S.A. |
| |
Abstract: | Summary Serum elastase 1 has been evaluated in 115 patients with pancreatic and nonpancreatic gastrointestinal diseases and in 36
healthy controls. Increased serum elastase 1 values were found in all 27 patients with acute pancreatitis. If the diagnostic
cutoff was established as the 2-fold increase above the upper normal range, sensitivity of elastase 1 (100%) was superior
to pancreatic lipase (90%), immunoreactive trypsin (87%) and pancreatic amylase (78%). Specificity was 96% for elastase 1
at this cutoff. No distinction was possible between edematous and necrotizing acute pancreatitis on the basis of peak serum
elastase 1 concentrations.
Among 32 patients with chronic pancreatitis increased serum elastase 1 values were found in 22% and decreased values in 16%
of patients, showing a striking parallelism to serum values of pancreatic lipase and immunoreactive trypsin. Specificity,
established in controls and 49 patients with different gastrointestinal diseases, was 77% for elastase 1, 76% for immunoreactive
trypsin, 83% for pancreatic lipase and 91% for pancreatic amylase. In addition, we investigated 21 patients with severe chronic
renal diseases.
In patients with renal insufficiency elastase was increased in 33%, comparable to the frequency of increased amylase and pancreatic
amylase serum levels, whereas immunoreactive trypsin was increased in 95%. Immunoreactive trypsin showed a significant correlation
to creatinin serum concentration, whereas the other enzymes did not. |
| |
Keywords: | Serum elastase Pancreatic amylase Pancreatic lipase Immunoreactive trypsin Acute pancreatitis Chronic pancreatitis Renal insufficiency |
本文献已被 SpringerLink 等数据库收录! |
|