Normal lipase drug-induced pancreatitis: a novel finding

Shafqet, Muhammad A.; Brown, Teresa; Sharma, Ranita

doi:10.1016/j.ajem.2014.08.056

Cited by 12 publications

(5 citation statements)

References 9 publications

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“…[ 14 16 17 18 ] On the other hand, there are several reports of either normal or <3× ULN lipase levels in patients with radiologically confirmed AP, with little known about the value of simultaneously measured amylase. [ 19 20 21 22 23 40 ] In our cohort, 6 of 125 (4.8%) patients were diagnosed with elevated amylase levels. Despite the known low sensitivity, serum amylase was helpful as a supplemental test and identified a subset of AP patients presenting with non-diagnostic serum lipase levels.…”

Section: Discussionmentioning

confidence: 95%

“…[ 7 10 11 12 13 14 15 16 17 18 ] Nonetheless, AP presenting with non-diagnostic serum lipase has been reported while little is known about the diagnostic role of the simultaneous measurement of serum amylase in such a scenario. [ 19 20 21 22 23 24 25 ] This study aimed to examine the contribution of pancreatic enzymes and imaging in the diagnosis of first-attack AP in children and explore the diagnostic value of simultaneously measured serum amylase in children presenting with non-diagnostic serum lipase.…”

Section: Introductionmentioning

confidence: 99%

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Serum pancreatic enzymes and imaging in paediatric acute pancreatitis

Al-Edreesi

AlAwamy

2022

Saudi Journal of Gastroenterology

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Background: In acute pancreatitis (AP), serum amylase, lipase and imaging help establish a diagnosis with recognised lipase superiority. Recent literature has debated serum amylase testing and proposed its elimination, but little is known about the diagnostic role of simultaneously measured serum amylase levels in patients with non-diagnostic lipase. This study examined the contribution of pancreatic enzymes and imaging and the role of simultaneously measured serum amylase in children with non-diagnostic serum lipase. Methods: Retrospective medical records review of children aged <18 years with a verified discharge diagnosis of first-attack AP between January 01, 1994, and December 31, 2016. Results: First-attack AP was confirmed in 127 children (median age, 12.5 years). The sensitivity was 90.4%, 54.3%, 42.2% and 36.4% for lipase, amylase, contrast-enhanced computed tomography and ultrasonography (US), respectively. Combination US and lipase identified 96.6% of AP cases. Simultaneous amylase and lipase measurements in 125 children showed that either was ≥3× the upper limit of normal (ULN) in 95.2%, while both were <3× the ULN in 4.8% of cases. Nondiagnostic lipase was seen in 12 (9.6%) children, and diagnosis was based on amylase level ≥3× the ULN in six children and imaging in the other six. Conclusions: Serum amylase, serum lipase and imaging should continue for the conclusive diagnosis of AP in children. Simultaneous serum amylase measurement helped diagnose AP with non-diagnostic lipase.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Serum pancreatic enzymes and imaging in paediatric acute pancreatitis

Al-Edreesi

AlAwamy

2022

Saudi Journal of Gastroenterology

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“…With the development of biotechnologies, esterases have been widely used in medicine, food, fine chemicals, and biodiesel industries due to their excellent biological properties [12][13][14]. However, their use in industrial processes has many restrictions under prolonged catalytic reaction conditions or in the presence of organic solvents.…”

Section: Introductionmentioning

confidence: 99%

Cloning, Expression, and Characterization of a Novel Thermostable and Alkaline-stable Esterase from Stenotrophomonas maltophilia OUC_Est10 Catalytically Active in Organic Solvents

Gao

Mao

et al. 2019

Catalysts

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A thermostable and alkaline-stable novel esterase (Est7) was identified through the whole genome sequencing of Stenotrophomonas maltophilia OUC_Est10. The open reading frame of this gene encoded 617 amino acid residues. After heterologous expression in Escherichia coli BL21 (DE3), the purified Est7 was separated as a single protein and presented a molecular mass of 70.6 kDa. Multiple sequence alignment indicated that Est7 had a typical catalytic triad (Ser-Asp-His) and the conserved sequence (GDSL) typical of the family II lipid hydrolase proteins. Est7 showed good stability in alkaline buffers, especially in Tris-HCl buffer at pH 9.0 (residual activity 93.8% after 96 h at 4 °C) and in the medium temperature conditions (residual activity 70.2% after 96 h at 45 °C and pH 8.0). The enzyme also retained higher stability toward several hydrophilic and hydrophobic organic solvents (e.g., after incubation in 100% acetonitrile or in n-hexane the enzyme retained about 97% and 84% of the activity in the absence of organic solvent, respectively). Furthermore, Est7 could catalyze the transesterification reaction of vinylacetate with 2-phenylethanol and cis-3-hexen-1-ol to their corresponding acetate esters in petroleum ether or tert-butyl methyl ether. These results indicate Est7 as a promising biocatalyst for applications of Est7 in non-aqueous media.

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“…There have been case reports in the past supporting the possibility of normal lipase levels, particularly in cases of acute on chronic pancreatitis, hypertriglyceridemia induced or in late presentations, none of which fit this clinical scenario. [9][10][11][12][13]…”

Section: Discussionmentioning

confidence: 99%

Pancreatitis with a Normal Serum Lipase, a Rare Post-esophagogastroduodenoscopy Complication: A Case Report

Sturlis

McGrane

2022

Clinical Practice and Cases in Emergency Medicine

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Introduction: Pancreatitis after esophagogastroduodenoscopy (EGD) is not a common occurrence, particularly in the setting of a normal serum lipase. The lack of commonality may delay diagnosis and treatment in some patients presenting to the emergency department (ED) with abdominal pain after an otherwise uncomplicated procedure. Case Report: A patient with a history of gastroesophageal reflux disease presented to the ED with a complaint of abdominal pain and fever three days after an uncomplicated EGD. The patient was ultimately diagnosed with pancreatitis after a computed tomography showed pancreatic head inflammation, despite having a normal serum lipase. There were no other identified risk factors for pancreatitis in this case. Conclusion: This case serves to bring awareness to this potential procedural complication and the possibility of pancreatitis with a normal serum lipase.

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Normal lipase drug-induced pancreatitis: a novel finding

Cited by 12 publications

References 9 publications

Serum pancreatic enzymes and imaging in paediatric acute pancreatitis

Serum pancreatic enzymes and imaging in paediatric acute pancreatitis

Cloning, Expression, and Characterization of a Novel Thermostable and Alkaline-stable Esterase from Stenotrophomonas maltophilia OUC_Est10 Catalytically Active in Organic Solvents

Pancreatitis with a Normal Serum Lipase, a Rare Post-esophagogastroduodenoscopy Complication: A Case Report

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