Use of the urinary trypsinogen-2 dip stick test in early diagnosis of pancreatitis after endoscopic retrograde cholangiopancreatography

Sankaralingam, Sowndramalingam; Wesen, Cheryl; Barawi, Mohammed; Galera, Rosa María López; Lloyd, Larry R.

doi:10.1007/s00464-006-9099-2

Cited by 19 publications

(12 citation statements)

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“…On the other hand, UTDT positivity lasted for an average of 3.6 ± 2.1 d (range, 2-13) in patients in the study group. APACHE Ⅱ score (cut-off > 8) was 6.1 ± 2.7 (range, 3-13) and 4.6 ± 1.5 (range, [3][4][5][6][7][8] in the study and control groups, respectively (P = 0.006) ( Table 2). Of the patients with AP, 66 (71.7%) had mild disease and 26 (28.3%) had severe disease according to the Atlanta classification [1] .…”

Section: Resultsmentioning

confidence: 99%

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Early diagnosis and prediction of severity in acute pancreatitis using the urine trypsinogen-2 dipstick test: A prospective study

Erdinc¹,

Kamer²,

Haluk³

et al. 2007

WJG

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AIM:To evaluate the use of the trypsinogen-2 dipstick (Actim Pancreatitis) test for early diagnosis and prediction of severity in acute pancreatitis (AP). METHODS:Ninety-two patients with AP were included in this study. The control group was 25 patients who had acute abdominal pain from non-pancreatic causes. Urine trypsinogen-2 dipstick test (UTDT) and conventional diagnostic tests were performed in all patients. Patients were divided by the Atlanta classification into two groups as having mild or severe pancreatitis. RESULTS:UTDT was positive in 87 (94.6%) of the AP patients and in two (8%) controls (P < 0.05). Positive UTDT was found in 61 (92.4%) of 66 (71.7%) patients with mild pancreatitis and in all (100%) of the 26 (28.3%) with severe pancreatitis (P > 0.05). UTDT positivity lasted longer in severe pancreatitis compared with that in mild pancreatitis (6.2 ± 2.5 d vs 2.0 ± 1.43 d, P < 0.05).The sensitivity, specificity, positive predictive value, negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of UTDT were 91%, 72%, 96.6%, 70.4%, 3.4 and 0.1, respectively. CONCLUSION:UTDT is a simple, rapid and reliable method for use on admission. It has high specificity and low NLR for early diagnosis and prediction of severity in AP. However, its relatively low NPV does not allow trypsinogen-2 dipstick test to be a stand-alone tool for diagnosis of acute pancreatitis; the use of other conventional diagnostic tools remains a requirement.

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Section: Resultsmentioning

confidence: 99%

“…Hence, early diagnosis and prediction of severity in AP has particular significance [1][2][3][4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Early diagnosis and prediction of severity in acute pancreatitis using the urine trypsinogen-2 dipstick test: A prospective study

Erdinc¹,

Kamer²,

Haluk³

et al. 2007

WJG

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“…Finally, recently published pilot studies have evaluated the screening potential of urinary trypsinogen-2 dipstick in the setting of post endoscopic retrograde cholangiopancreatography-induced AP 29 and postoperative AP. 30 These results seem promising, but there is a need for further evaluation in these settings.…”

Section: Discussionmentioning

confidence: 98%

Urinary Trypsinogen-2 Dipstick in Acute Pancreatitis

Andersen

Novovic²,

Ersbøll³

et al. 2010

Pancreas

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Objectives To determine the frequency of raised Urinary Trypsinogen-2 in diagnosed patients of acute pancreatitis. Methodology Settings Patients in emergency refer to General Surgery ward-3 Jinnah Post Graduate and Medical Centre Karachi. Duration Six months, started from 20-01-2012 to 19-07-2012. Study Design Cross sectional descriptive study. Subjects and Methods All cases of Acute Pancreatitis diagnosed by Upper Abdominal Pain, Raised Serum Amylase and/or Serum Lipase and Abdominal CT Scan findings, were included in the study. Urinary Trypsinogen-2 dipstick test was done. All patient related data including age, gender, sex and raised Urinary Trypsinogen-2 or normal, was recorded. Data analysis was done on SPSS version 10. Frequency and percentage was calculated for gender and raised trypsinogen-2. Age and gender wise stratification was done to see the effect of these variables on outcome. Results Mean age of the patients was 38.14 ±7.42 years. The minimum age was 24 years, while the maximum age was 63 years. Raised urinary trypsinogen-2 level was present in 55 (65.5%) patients. Stratification of age group shows, that 40 (66.7%) patients in age group ≤ 40 years had raised urinary trypsinogen-2. Stratification of gender showed significant association with raised urinary trypsinogen-2 level (p-value 0.010). Conclusion The frequency of raised Urinary Trypsinogen-2 in diagnosed patients of acute pancreatitis was found to be high.

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“…Some studies have advocated the use of urinary trypsinogen-2 as a screening tool, with a positive result indicating a need for further evaluation of acute pancreatitis. [18][19][20] Urinary trypsinogen-2 is less costly than serum tests, plus may result in additional cost savings with earlier patient discharge. Unfortunately, this test is not widely available for clinical use.…”

Section: Etiologymentioning

confidence: 99%

Acute pancreatitis

Munsell

Buscaglia

2010

Journal of Hospital Medicine

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Acute pancreatitis is a common disease most frequently caused by gallstone disease or excess alcohol ingestion. Diagnosis is usually based on characteristic symptoms, often in conjunction with elevated serum pancreatic enzymes. Imaging is not always necessary, but may be performed for many reasons, such as to confirm a diagnosis of pancreatitis, rule out other causes of abdominal pain, elucidate the cause of pancreatitis, or to evaluate for complications such as necrosis or pseudocysts. Though the majority of patients will have mild, self‐limiting disease, some will develop severe disease associated with organ failure. These patients are at risk to develop complications from ongoing pancreatic inflammation such as pancreatic necrosis, fluid collections, pseudocysts, and pancreatic duct disruption. Validated scoring systems can help predict the severity of pancreatitis, and thus, guide monitoring and intervention.Treatment of acute pancreatitis involves supportive care with fluid replacement, pain control, and controlled initiation of regular food intake. Prophylactic antibiotics are not recommended in acute pancreatitis if there is no evidence of pancreatic infection. In patients who fail to improve, further evaluation is necessary to assess for complications that require intervention such as pseudocysts or pancreatic necrosis. Endoscopy, including ERCP and EUS, and/or cholecystectomy may be indicated in the appropriate clinical setting. Ultimately, the management of the patient with severe acute pancreatitis will require a multidisciplinary approach. Journal of Hospital Medicine 2010;5:241–250. © 2010 Society of Hospital Medicine.

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Use of the urinary trypsinogen-2 dip stick test in early diagnosis of pancreatitis after endoscopic retrograde cholangiopancreatography

Abstract: The urinary trypsinogen-2 dip stick test is useful for early diagnosis of post-ERCP pancreatitis and allows the testing physicians to begin management early in its course.

Cited by 19 publications

References 8 publications

Early diagnosis and prediction of severity in acute pancreatitis using the urine trypsinogen-2 dipstick test: A prospective study

Early diagnosis and prediction of severity in acute pancreatitis using the urine trypsinogen-2 dipstick test: A prospective study

Urinary Trypsinogen-2 Dipstick in Acute Pancreatitis

Acute pancreatitis

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