PANCREATITIS OR NOT? – Elevated lipase and amylase in ICU patients |
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| Institution: | 1. Section of Digestive Disease, Yale University School of Medicine, New Haven, CT;2. Department of surgery, Mount Sinai Beth Israel Medical center, New York, NY;3. Division of Gastroenterology, Hepatology, and Clinical Nutrition, Saint Peters University Hospital, New Brunswick, NJ, USA;2. Sports Medicine & Shoulder Service, Department of Orthopaedic Surgery, University of Michigan Ann Arbor, MI;1. Chemistry Department, Federal State Budgetary Educational Institution of Higher Education “Moscow State Academy of Veterinary Medicine and Biotechnology - MVA by K.I. Skryabin”, Moscow 109472, Russia;2. Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow 177997, Russia;1. Institut de Recerca de l''HSCSP – Institut d''Investigacions Biomèdiques (IIB) Sant Pau, Barcelona, Spain;2. Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Barcelona, Spain;3. CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Barcelona, Spain;4. Hospital de la Santa Creu i Sant Pau, Servei de Bioquímica, Barcelona, Spain;1. Northwell Health Long Island Jewish Medical Center, Department of Emergency Medicine, New Hyde Park, NY;2. California State University, Northridge, Department of Health Sciences, Division of Biostatistics;3. New York University, Winthrop Hospital, Emergency Department, Mineola, NY;4. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health Long Island Jewish Medical Center, Department of Emergency Medicine, New Hyde Park, NY |
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| Abstract: | Elevation in serum levels of pancreatic enzymes (Hyperamylasemia and/or Hyperlipasemia) can occur in any Intensive Care Unit (ICU) patient either as a result of true acute pancreatitis (AP) or as a reflection of a non-pancreatic disease. Although most patients may not have clinical pancreatitis, identifying true acute pancreatitis in the ICU setting may be critical in the presence of associated co-morbid conditions of the disease for which the patient is being managed. With neither amylase nor lipase being specific for pancreatitis, it is important for the clinician to be aware of different causes of hyperamylasemia and hyperlipasemia, especially when clinical diagnosis of pancreatitis is unclear. This review will focus on understanding different non-pancreatic conditions where there is elevation of pancreatitis enzymes and to identify true acute pancreatitis in critically ill patients without typical symptoms. |
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