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Clinical Chemistry 37: 356-360, 1991;
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Clinical Chemistry, Vol 37, 356-360, Copyright © 1991 by American Association for Clinical Chemistry

Diagnostic and prognostic utility of phospholipase A activity in patients with acute pancreatitis: comparison with amylase and lipase

SC Kazmierczak, F Van Lente and ED Hodges
Department of Clinical Pathology and Diagnostic Medicine, East Carolina University School of Medicine, Greenville, NC 27858.

We compared the diagnostic and prognostic utility of phospholipase A (PLA; EC 3.1.1.4) for acute pancreatitis with that of amylase and lipase by analysis of sera from 151 consecutive patients presenting with abdominal pain in whom assays of serum amylase and (or) lipase had been ordered. We determined the diagnostic accuracy for both the initial and the peak enzyme activities. Maximal diagnostic accuracy obtained for the initial activities of amylase, lipase, and PLA was 0.83, 0.83, and 0.76 at cutoff values of 650, 650, and 41 U/L, respectively. Use of peak enzyme activities showed maximal diagnostic accuracy of 0.85, 0.86, and 0.73 at cutoff values of 650, 1050, and 42 U/L, respectively. Receiver-operator characteristic curve analysis revealed the diagnostic performance of amylase and lipase to be similar, whereas that of PLA was almost random and not incremental. As with amylase and lipase, PLA activities in sera showed no relation to patients' survival; three patients who died after an attack of acute pancreatitis failed to demonstrate the dramatic increases in PLA activity previously described. We conclude that assessing the severity of acute pancreatitis by using enzyme activities still remains problematical. Measurements of amylase or lipase activities provide similar diagnostic discrimination when appropriate cutoff values are used and remain the methods of choice for diagnosis of acute pancreatitis.


The following articles in journals at HighWire Press have cited this article:


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 Emerg. Med. J.Home page
J. Butler and K. Mackway-Jones
Serum amylase or lipase to diagnose pancreatitis in patients presenting with abdominal pain
Emerg. Med. J., September 1, 2002; 19(5): 430 - 431.
[Abstract] [Full Text]


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Copyright © 1991 by the American Association for Clinical Chemistry.