amylase/lipase in ETOH pancreatitis

Q: Which test is more reliable in acute alcoholic pancreatitis? (select one)

A) Amylase
B) Lipase



Answer: B

In non-alcoholic acute pancreatitis serum amylase usually rises more than three times the normal but chronic alcoholic patients may not be able to produce this elevation as their parenchyma lacks both in quality as well as in quantity. Also, amylase has a short half-life, less parenchyma for it's production and patients with ETOH abuse history tends to present more than 24 hours after the attack.

Serum lipase is specific to pancreas, has a longer half-life in days and requires less parenchyma to get produce.

#gastroenterology
#laboratory-medicine


References:

1. Yadav D, Agarwal N, Pitchumoni CS. A critical evaluation of laboratory tests in acute pancreatitis. Am J Gastroenterol 2002; 97:1309. 

2. Frank B, Gottlieb K. Amylase normal, lipase elevated: is it pancreatitis? A case series and review of the literature. Am J Gastroenterol 1999; 94:463. 

3. Treacy J, Williams A, Bais R, et al. Evaluation of amylase and lipase in the diagnosis of acute pancreatitis. ANZ J Surg 2001; 71:577.