Diagnostic value of immunoreactive phospholipase A2 in acute pancreatitis

Malfertheiner, Peter; Nevalainen, Timo J.; Uhl, Waldemar; Schädlich, H.; Büchler, Markus W.

doi:10.1007/bf01711350

Cited by 10 publications

(1 citation statement)

References 7 publications

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“…Until the late 80's PLA 2 levels in acute pancreatitis were believed to be exclusively of pancreatic origin. The group I-PLA 2 concentration determined with an immunoassay correlated closely with lipase and amylase (1). Soon it became evident that the course of total serum PLA 2 activity did not correlate with the kinetics of other pancreatic enzymes but followed those of inflammatory indicators like C-reactive protein (CRP).…”

Section: Introductionmentioning

confidence: 99%

Pancreatic Phospholipase A2 Activity in Acute Pancreatitis: a Prognostic Marker for Early Identification of Patients at Risk

Aufenanger

Samman²,

Quintel³

et al. 2002

Clinical Chemistry and Laboratory Medicine

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Remarkably elevated levels of phospholipase A 2 (PLA 2 ) are measurable in human blood samples in cases of acute pancreatitis. The source of the enzyme was first thought to be exclusively the pancreas, but now it is generally accepted that two isoenzymes − the pancreatic PLA 2 , group I, and the extrapancreatic PLA 2 , group II − contribute to the raised activity. In contrast to the group II-PLA 2 , the pancreatic PLA 2 is heat-resistant for 1 hour at 60 °C. The catalytically inactive proenzyme of the pancreatic PLA 2 can be activated by trypsin. The aim of our study was to evaluate the diagnostic value of PLA 2 isoenzyme activity measurements to identify patients with severe complications in acute pancreatitis. Blood samples from patients suffering from acute pancreatitis were analyzed for catalytically active pancreatic PLA 2 on day 1 and 2 of hospitalization with a modified radiometric Escherichia coli-based PLA 2 assay. In 10 of 41 patients clearly elevated values of catalytically active, heat-resistant pancreatic PLA 2 (7.2 to 81.2 U/l) were observed. This group of patients was characterized by severe complications (necrotizing pancreatitis, shock, sepsis, respiratory problems) of which two patients subsequently died. Patients with low or undetectable activity (<7 U/l) of pancreatic PLA 2 recovered rapidly. According to these results the presence of catalytically active pancreatic PLA 2 in serum is associated with severe complications of acute pancreatitis. In contrast to total serum-PLA 2 , the catalytic concentration of pancreatic PLA 2 can serve as a prognostic marker in acute pancreatitis. Clin Chem Lab Med 2002; 40(3):293-297

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Section: Introductionmentioning

confidence: 99%

Pancreatic Phospholipase A2 Activity in Acute Pancreatitis: a Prognostic Marker for Early Identification of Patients at Risk

Aufenanger

Samman²,

Quintel³

et al. 2002

Clinical Chemistry and Laboratory Medicine

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Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis

Rompianesi

Hann

Komolafe

et al. 2017

Cochrane Database of Systematic Reviews

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As about a quarter of people with acute pancreatitis fail to be diagnosed as having acute pancreatitis with the evaluated tests, one should have a low threshold to admit the patient and treat them for acute pancreatitis if the symptoms are suggestive of acute pancreatitis, even if these tests are normal. About 1 in 10 patients without acute pancreatitis may be wrongly diagnosed as having acute pancreatitis with these tests, therefore it is important to consider other conditions that require urgent surgical intervention, such as perforated viscus, even if these tests are abnormal.The diagnostic performance of these tests decreases even further with the progression of time, and one should have an even lower threshold to perform additional investigations if the symptoms are suggestive of acute pancreatitis.

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Prognostic value of serum phospholipase A in acute pancreatitis

et al. 1989

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Serum from 48 patients with acute pancreatitis (21 with interstitial-edematous and 27 with necrotizing pancreatitis) was monitored for immunoreactive (IR) phospholipase A2 (PLA2) protein concentration and PLA catalytic activity. In both groups within 48 h after start of acute pancreatitis an up to tenfold increase of IR-PLA2 was demonstrable. Determination of IR-PLA2 revealed no differences between the groups. In contrast, determination of PLA catalytic activity allowed us to differentiate between patients with interstitial-edematous and necrotizing pancreatitis.

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Diagnostic value of immunoreactive phospholipase A2 in acute pancreatitis

Cited by 10 publications

References 7 publications

Pancreatic Phospholipase A2 Activity in Acute Pancreatitis: a Prognostic Marker for Early Identification of Patients at Risk

Pancreatic Phospholipase A2 Activity in Acute Pancreatitis: a Prognostic Marker for Early Identification of Patients at Risk

Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis

Prognostic value of serum phospholipase A in acute pancreatitis

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