Serum lipase: a better test to diagnose acute alcoholic pancreatitis

Abstract

Objective: To determine whether serum lipase is a better test than serum amylase to diagnose acute alcoholic pancreatitis.

Patients: Two hundred two asymptomatic chronic alcoholics (Group A) and 29 patients with image-proven pancreatitis (Group P).

Measurements: Serum lipase was measured using the Kodak Ektachem clinical chemistry slide. Serum amylase was estimated using the Kodak Ektachem clinical chemistry slide or the Beckman Astra amylase chemistry module.

Results: The level of serum amylase in Group A ranged from 17 to 347 U/L (mean 71, SD +/- 36 U/L) and in Group P from 180 to 2,985 U/L (mean 722, SD +/- 663 U/L). Thirteen of 29 patients (45%) with image-proven pancreatitis had levels that overlapped those found in asymptomatic alcoholics. The serum lipase levels in Group A ranged from 34 to 600 U/L (mean 186, SD +/- 111 U/L), while in Group P, the corresponding figures were 1,011 to 25,706 U/L (mean 5,822, SD +/- 5,664 U/L). None of the 29 patients with image-proven pancreatitis had levels that overlapped those found in asymptomatic alcoholics.

Conclusions: Serum lipase is a better test that serum amylase to diagnose acute alcoholic pancreatitis.