Serum C-reactive protein, procalcitonin, and lactate dehydrogenase for the diagnosis of pancreatic necrosis

Abstract

The paucity of data and methodological deficiencies in the studies meant that it was not possible to arrive at any conclusions regarding the diagnostic test accuracy of the index test because of the uncertainty of the results. Further well-designed diagnostic test accuracy studies with prespecified index test thresholds of CRP, procalcitonin, LDH; appropriate follow-up (for at least two weeks to ensure that the person does not have pancreatic necrosis, as early scans may not indicate pancreatic necrosis); and clearly defined reference standards (of surgical or radiological confirmation of pancreatic necrosis) are important to reliably determine the diagnostic accuracy of CRP, procalcitonin, and LDH.

CONUT score is associated with mortality in patients with COVID-19: a retrospective study in Wuhan

“…In fact, CRP also takes part in the innate host defense by binding to pathogens and promoting their elimination by phagocytes [53]. Existed in all body cells, especially the myocardial and liver cells, LDH is bene cial to evaluate severity of tissue damage in early stage [54]. Increased LDH is also associated with immunosuppression by promoting the production of lactate which in turn strengthen the immunosuppressive cells and weaken the cytolytic cells [55].…”

Predicting Severity in Acute Pancreatitis: A Never-Ending Quest…

“…This conclusion follows other studies, though ideal cutoff points remain to be determined [17]. Furthermore, a recent Cochrane review failed to determine the role of CRP in the diagnosis of pancreatic necrosis [18]. Currently, guidelines advise against the use of a single biomarker to triage patients, but CRP levels ≥150 mg/dL at 48 h are accepted as a predictor of worse prognosis.…”

In response to fluid resuscitation with lactated Ringer’s solution vs. normal saline in acute pancreatitis: A triple-blind, randomized, controlled trial

“…6 Moreover, in the last diagnostic review by the Cochrane Collaboration, the authors explained that all the studies that were undertaken about the diagnostic development and accuracy of CRP in acute pancreatitis weren't strong enough and more research has to be conducted in the future on the implementation of these serum inflammatory markers (most of the LRs in this review weren't very strong or did not suggest good development). 7 In conclusion, we do think this clinical trial is an interesting study that compares two different options for the hydration treatment of acute pancreatitis; however, the employment of CRP might be not so accurate as a good surrogate maker for AP during the study.…”