SERUM INTERLEUKIN-6 IN THE PROGNOSIS OF ACUTE BILIARY PANCREATITIS

Background, Data concerning the interleukin 6 pattern in acute biliary pancreatitis are lacking. Aim, To define the best cut-off point of th is molecule in differentiating the severe form of acute biliary pancre atitis from the mild form and to evaluate its sensitivity specificity and diagnostic accuracy in the prognosis of acute biliary pancreatitis in comparison with those of serum C-reactive protein. Patients, Forty -four patients with acute biliary pancreatitis: 27 patients with mild pancreatitis and 17 with the severe form of the disease. Methods, Seru m interleukin-6 and C-reactive protein concentrations were assessed in all patients on admission and for the following 5 days. Results, Seru m interleukin-6 levels were significantly higher (p<0.02) in patients with severe acute biliary pancreatitis than in those with the mild for m of the disease. No significant difference in serum C-reactive protei n levels was found in the first 2 days in patients with mild biliary p ancreatitis when compared to those with the severe form of the disease . Using a cut-off point of 2.7 pg/ml for serum interleukin-6 and II mg /dl for serum C-reactive protein, the sensitivity of the two molecules in assessing the severity of acute pancreatitis on the first day of t he study was 87.5% for interleukin-6 and 6.3% for C-reactive protein, the specificity 83.3% for interleukin-6 and 91.7% for C-reactive prote in, and the accuracy 85.0% for interleukin-6 and 57.5% for C-reactive protein. Conclusions. Serum determination of interleukin-6 in the firs t 24 hours of the disease is a better marker of the severity of acute biliary pancreatitis than C-reactive protein.