Q: What one advantage urinary trypsinogen activation peptide (TAP) has over amylase and lipase in acute pancreatitis? 

Answer: Trypsinogen activation peptide (TAP) is a five amino-acid peptide elevated in acute pancreatitis. It is cleaved from trypsinogen to become active trypsin. Though it may only be of academic interest but it is one of the earliest marker of acute pancreatitis, as well as it co-relates with severity of acute pancreatitis.


References: 

1. Tenner S, Fernandez-del Castillo C, Warshaw A, et al. Urinary trypsinogen activation peptide (TAP) predicts severity in patients with acute pancreatitis. Int J Pancreatol 1997; 21:105. 

2. Khan Z, Vlodov J, Horovitz J, et al. Urinary trypsinogen activation peptide is more accurate than hematocrit in determining severity in patients with acute pancreatitis: a prospective study. Am J Gastroenterol 2002; 97:1973.