Biochemical Indicators of Acute Pancreatitis

  • Steven C. Kazmierczak
Part of the Pathology and Laboratory Medicine book series (PLM, volume 2)


One of the earliest biochemical markers employed for the diagnosis of a particular disease state was reported in 1916 by Stocks (1), who suggested that amylase activity in blood and urine was a sensitive and reliable test for various pancreatic disorders. Since this time, numerous other enzymatic markers of pancreatic disease have been described. Although there is a large body of literature indicating that some of these other tests may provide better diagnostic accuracy of acute pancreatitis when compared with serum amylase, none of these newer tests have replaced amylase. Amylase remains among one of the top 20 most frequently requested clinical assays and is an important component of emergency laboratory services (2). Recent studies, however, have demonstrated that other markers in addition to amylase offer greater clinical specificity for the diagnosis of acute pancreatitis and should replace amylase as the primary test for this disease. As stated by Tietz, “old myths die hard” (3). It will probably take years before the diagnostic utility of these other tests are recognized. This section reviews the diagnostic utility of both the commonly used and more esoteric indicators of acute pancreatitis. The analytes most frequently employed for the diagnosis of acute pancreatitis include amylase and the pancreatic isoenzyme of amylase and lipase. The markers infrequently used, but that may provide good diagnostic and/or prognostic information, include trypsin, phospholipase A (PLA), carboxypeptidase A, and lipase isoforms.


Acute Pancreatitis Disseminate Intravascular Coagulation Severe Acute Pancreatitis Amylase Activity Pancreas Divisum 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Humana Press Inc. 1997

Authors and Affiliations

  • Steven C. Kazmierczak

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