Chronic pancreatitis laboratory findings: Difference between revisions
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* The diagnosis of chronic pancreatitis is typically based on tests on pancreatic structure and function, as direct biopsy of the pancreas is considered excessively risky. | * The diagnosis of chronic pancreatitis is typically based on tests on pancreatic structure and function, as direct biopsy of the pancreas is considered excessively risky. | ||
* Serum [[amylase]] and [[lipase]] may | * Serum [[amylase]] and [[lipase]] are usually normal but may be slightly elevated (neither diagnostic nor prognostic). | ||
* The following lab tests are usually normal: | |||
** CBC | |||
** LFTs | |||
** Electrolytes | |||
* A [[secretin]] stimulation test is considered the gold standard functional test for diagnosis of chronic pancreatitis. The observation that bi-carbonate production is impaired early in chronic pancreatitis has led to the rationale of use of this test in early stages of disease ([[sensitivity]] of 95%). | * A [[secretin]] stimulation test is considered the gold standard functional test for diagnosis of chronic pancreatitis. The observation that bi-carbonate production is impaired early in chronic pancreatitis has led to the rationale of use of this test in early stages of disease ([[sensitivity]] of 95%). |
Revision as of 02:32, 6 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory Findings
- The diagnosis of chronic pancreatitis is typically based on tests on pancreatic structure and function, as direct biopsy of the pancreas is considered excessively risky.
- Serum amylase and lipase are usually normal but may be slightly elevated (neither diagnostic nor prognostic).
- The following lab tests are usually normal:
- CBC
- LFTs
- Electrolytes
- A secretin stimulation test is considered the gold standard functional test for diagnosis of chronic pancreatitis. The observation that bi-carbonate production is impaired early in chronic pancreatitis has led to the rationale of use of this test in early stages of disease (sensitivity of 95%).
- Other common tests used to determine chronic pancreatitis are:
- Faecal elastase measurement
- Serum trypsinogen.
- There are other non-specific laboratory studies useful in the diagnosis of chronic pancreatitis:
- Serum bilirubin and alkaline phosphatase can be elevated, indicating stricturing of the common bile duct due to edema, fibrosis or cancer.
- Elevations in ESR, IgG4, rheumatoid factor, ANA and antismooth muscle antibody may be seen when the cause is autoimmune.
- steatorrhea can be diagnosed by two different studies:
- Sudan staining of feces or
- Fecal fat excretion over 24hr on a 100g fat diet.
- Fecal elastase measurement- the most sensitive and specific test for pancreatic exocrine dysfunction, which can be done with a single stool sample, and a value of less than 200 ug/g indicates pancreatic insufficiency.[1]
References
- ↑ Freedman SD. "Clinical manifestations and diagnosis of chronic pancreatitis in adults". UpToDate.