Assessment of Usefulness of CRP, PMN Elastase, PCT and Il- 6 as Prognostic Factors in Patients with Acute Pancreatitis

B Jagan Mohan Reddy B Jagan Mohan Reddy,S.p Girish S.P Girish

doi:10.47008/ajs/2020.3.2.1

Abstract

Background: Acute pancreatitis is an inflammatory disease of the exocrine pancreas with rapid onset. The present study was conducted to assess the usefulness of CRP, PMN elastase, PCT and IL- 6 as prognostic factors in patients with acute pancreatitis. Subjects and Methods: The present study comprised 53 patients who presented with a diagnosis of Acute Pancreatitis. CRP was estimated by turbidimetric immunoassay using CRP/U2A-000 kit. PMN-Elastase was estimated by solid-phase enzyme immunoassay. Procalcitonin was estimated by the immuno- chromatographic test. IL-6 was estimated by Immuno-enzymatic assay. Results: There were 47 males and 6 females in the present study. The mean SD CRP in patients with mild pancreatitis was 44.35 53.04 and in severe pancreatitis was 174.80 14.55, PCT was seen in 4 in mild pancreatitis patients and 12 in severe pancreatitis patients, PMN- elastase level was 3.89 1087 in mild pancreatitis and 3.99 2.75 inn severe pancreatitis patients, IL-6 level was 129.63 319.08 in mild pancreatitis and 1166.76 818.06 in severe pancreatitis patients. The difference was significant (P< 0.05). CRP had higher (100) specificity as compared to PCT (81), PMN- E (10) and IL- 6 (90), Specificity found to be 88, 81, 97 and 94 respectively, PPV was 84, 74, 67 and 90 respectively, NPV was 100, 87, 62 and 94 respectively, accuracy was 92, 81, 62 and 92 respectively, AUC was 0.97, 0.81, 0.43 and 0.95 respectively. Conclusion: Authors found that CRP is the single best predictor of the severity of acute pancreatitis. IL-6 and PCT also are reliable predictors. PMN-Elastase needs to be assessed in patients with acute pancreatitis presenting early in the course of the illness.

Highlights

Acute pancreatitis (AP) is an inflammatory disease of the exocrine pancreas with rapid onset, fast and uncontrollable progress, which ranges from self-limited disease to severer progressive disease with organ dysfunction and death
[1] AP may develop into severe acute pancreatitis (SAP) that is associated with multiple organ failure and systemic inflammatory response syndrome (SIRS)
We found that mean± SD C-reactive protein (CRP) in patients with mild pancreatitis was 44.35±53.04 and in severe pancreatitis was 174.80±14.55, PCT was seen in 4 in mild pancreatitis patients and 12 in severe pancreatitis patients, PMN- elastase level was 3.89±1087 in mild pancreatitis and 3.99±2.75 inn severe pancreatitis patients, IL-6 level was 129.63±319.08 in mild pancreatitis and 1166.76±818.06 in severe pancreatitis patients

Summary

Introduction

Acute pancreatitis (AP) is an inflammatory disease of the exocrine pancreas with rapid onset, fast and uncontrollable progress, which ranges from self-limited disease to severer progressive disease with organ dysfunction and death. [1] AP may develop into severe acute pancreatitis (SAP) that is associated with multiple organ failure and systemic inflammatory response syndrome (SIRS). [2] Acute pancreatitis is an inflammatory process that occurs in a normal organ and is diagnosed mainly by acute abdominal pain associated with a concomitant rise of serum amylase and lipase concentrations. Acute pancreatitis (AP) is an inflammatory disease of the exocrine pancreas with rapid onset, fast and uncontrollable progress, which ranges from self-limited disease to severer progressive disease with organ dysfunction and death. [1] AP may develop into severe acute pancreatitis (SAP) that is associated with multiple organ failure and systemic inflammatory response syndrome (SIRS). Acute pancreatitis is an inflammatory disease of the exocrine pancreas with rapid onset. The present study was conducted to assess the usefulness of CRP, PMN elastase, PCT and IL- 6 as prognostic factors in patients with acute pancreatitis. PMN-Elastase was estimated by solid-phase enzyme immunoassay. PMN-Elastase needs to be assessed in patients with acute pancreatitis presenting early in the course of the illness

Methods

Results

Conclusion