Enzyme Levels

[Guest guest]

Kris in TN,

You wrote, " Are there any web-sites with some good information about

pancreatic enzyme levels and how long they stay in your system during an

attack? "

I saw that there had been several answers to this question already, so at the

risk of duplicating information, I wanted to post these well defined

statements regarding the enzyme levels in relationship to the disease process. I

think

they are clear and concise.

Laboratory Diagnosis

Amylase. Serum amylase levels in patients with pancreatitis vary depending on

the severity of the disease. On average, during uncomplicated cases, the

serum amylase level starts increasing from two to 12 hours after the onset of

symptoms and peaks at 12 to 72 hours. It usually returns to normal within one

week. Although it lacks sensitivity (75 to 92 percent) and specificity (20 to 60

percent), measurement of the serum amylase level is the most widely used method

of diagnosing pancreatitis. The advantages of amylase testing are that it is

quickly performed, easily obtained and inexpensive. However, a variety of

nonpancreatic conditions cause increased amylase levels.

Lipase. Lipase levels increase within four to eight hours of the onset of

clinical symptoms and peak at about 24 hours. Levels decrease within eight to 14

days. The specificity (50 to 99 percent) and sensitivity (86 to 100 percent)

of lipase measurements are better than those of amylase measurement,

particularly in detecting alcoholic pancreatitis. The specificity of lipase

measurement,

as well as amylase measurement, may be improved by raising the threshold to

at least three times the upper limit of the normal reference values.

Trypsin/Elastase. Based on median sensitivities and specificities, an

elevated trypsin level has a better likelihood ratio for detecting pancreatitis

than

the amylase level and is probably the most accurate serum indicator for acute

pancreatitis. The elastase level has not proved to be better than trypsin or

lipase levels in assisting the diagnosis of acute pancreatitis. However, a

serum trypsin assay is not widely available and therefore is not routinely used.

The information comes from the following articles:

http://www.aafp.org/afp/20000701/164.html

Karyn E. , RN

Executive Director, PAI

Toll Free: 1-

Home Office: Indianapolis, IN

http://www.pancassociation.org

Pancreatitis Association International

www.health.groups.yahoo.com/group/pancreatitis/