Serum lipase, C-reactive protein, and interleukin-6 levels in ERCP-induced pancreatitis

Abstract

Background: C-reactive protein (CRP) and interleukin-6 (IL-6) are elevated in acute pancreatitis. Limited studies have evaluated their role in ERCP-induced pancreatitis. The aim of this study was to assess the role of serum lipase, CRP, and IL-6 in ERCP-induced pancreatitis. Methods: Eighty-five patients (62 women, 23 men; mean age 43 years; range 16-85 years) who underwent ERCP were entered in a prospective trial. ERCP-induced pancreatitis was classified as mild, moderate, or severe. Serum levels of lipase, CRP, and IL-6 were measured before ERCP and at 12 to 24 hours and 36 to 48 hours after ERCP. Results: Mild, moderate, and severe pancreatitis occurred, respectively, in 9, 7, and 4 patients after ERCP. There were significant differences in levels of CRP and IL-6 but not lipase for patients with mild versus moderate and moderate versus severe pancreatitis. The mean CRP levels (mg/dL) at 12 to 24 hours were 0.98 ± 0.24 in mild pancreatitis, 3.89 ± 0.32 in moderate pancreatitis, and 12.0 ± 1.60 in severe pancreatitis. The levels, respectively, at 36 to 48 hours were 1.60 ± 0.31, 7.60 ± 0.74, and 25.0 ± 2.9. The mean IL-6 levels (pg/mL) at 12 to 24 hours were 16.6 ± 2.06 in mild pancreatitis, 73.0 ± 15.60 in moderate pancreatitis, and 235.5 ± 26.31 in severe pancreatitis. The levels at 36 to 48 hours were, respectively, 18.92 ± 3.28, 100.17 ± 11.56, and 438.2 ± 71.50. Conclusions: Serum CRP and IL-6 levels may be useful early markers for predicting the severity of ERCP-induced pancreatitis. (Gastrointest Endosc 2001;54:435-40.)