Serial Estimation of Serum Myeloperoxidase in Patients of Acute Pancreatitis: A Pilot Study

Abstract

Introduction: Acute Pancreatitis (AP) is an inflammatory condition having varied presentation ranging from a mild self-limiting illness to a severe disease with multi organ failure. Excessive recruitment of leukocytosis is an important pathophysiological feature and Myelo-Peroxidase (MPO) forms an important part of neutrophil induced inflammation. The current prognostic criteria are complex and cumbersome. Materials and methods: The present cross sectional pilot study serial estimation of plasma MPO levels were done at the time of admission and on 3, 7 and 14 days in patient of Acute Pancreatitis (n=64) patient with acute abdominal symptoms (n=15) otherthan acute pancreatitidand healthy volunteers (n=15). The values of serum MPO levels were correlated with Ransons`s score, Apache score, CT severity index and patient developing local and systemic complications due to acute pancreatitis. Serum MPO levels in (mU/ml) were measured by colorimetric Assay kit (bio Vision, USA). Statistical Analysis on SPSS (Windows version 21.0) Results: The mean serum MPO levels were significantly high in patients of AP as compared to controls comprising of patients with acute for to abdominal conditions and healthy individuals (mean 12.73 vs. 1.67 mU/ml. p<0.001). The highest levels of serum MPO were observed on the first day of mild and severe AP. The mean MPO levels in mild diseases (n=21 patients) were 3-10 mU/ml and 10-20 mU/ml in severe AP (n=43 patients) who also experienced higher local complications and worse outcome in terms of mortality. MPO returned to normal levels within 7-10days in mild but were persistently raised in patients with severe diseases. Conclusion: The higher serum MPO levels correlated with more severe diseases, worse outcome and can be a simple and effective prognostic indicator in AP.