AMYLASE, LIPASE, PANCREATIC ISOAMYLASE, AND PHOSPHOLIPASE-A IN DIAGNOSIS OF ACUTE-PANCREATITIS

To determine the utility of serum amylase (AMY), lipase (Lp), pancreat ic isoamylase (isoA), phospholipase A (PLA), and urine AMY in the diag nosis of acute pancreatitis, samples of serum and urine were obtained on admission and every day thereafter for 5 days from 384 patients wit h acute abdominal pain. Diagnostic accuracy, determined as the area un der the receiver operating characteristic curve, was >0.975 for serum AMY, Lp, isoA, and urine AMY. For each of these enzymes, a threshold v alue (twice to sixfold the upper limit of the reference values) offeri ng diagnostic efficiency >95% could be determined. In contrast, accura cy and efficiency of serum PLA were low. The profiles of these enzymes in acute pancreatitis decreased in a parallel fashion over 5 days exc ept for PLA. We conclude that diagnostic utilities are similar for ser um AMY, Lp, isoA, and urine AMY for acute pancreatitis, provided that an appropriate threshold is established.