Chronic pancreatitis laboratory findings

Chronic pancreatitis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Chronic pancreatitis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Abdominal X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
American Pancreatic Association Practice Guidelines
APA Clinical Practice Guidelines for Chronic pancreatiits
Chronic pancreatitis laboratory findings On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Chronic pancreatitis laboratory findings All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Chronic pancreatitis laboratory findings
CDC on Chronic pancreatitis laboratory findings
Chronic pancreatitis laboratory findings in the news
Blogs on Chronic pancreatitis laboratory findings
Directions to Hospitals Treating Chronic pancreatitis
Risk calculators and risk factors for Chronic pancreatitis laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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).
• Serum bilirubin and alkaline phosphatase levels may be elevated in case of intra-pancreatic biliary duct obstruction.
• 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%).
• Autoimmune pancreatitis can be diagnosed with elevated levels of:
  • ESR
  • IgG4
  • rheumatoid factor
  • ANA
  • Antismooth muscle antibody

Pancreatic function tests:

(c) Faecal elastase measurement:

• 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.

References

Template:WikiDoc Sources