Skip to main content
PMC home page
Gut logoLink to Gut
. 1987 Jun;28(6):764–771. doi: 10.1136/gut.28.6.764

C-reactive protein (CRP) and serum phospholipase A2 in the assessment of the severity of acute pancreatitis.

P Puolakkainen, V Valtonen, A Paananen, T Schröder
PMCID: PMC1433041  PMID: 3623221

Abstract

The present study examines the value of C-reactive protein (CRP) determinations in the assessment of the severity of acute pancreatitis and the correlation of CRP with serum phospholipase A2 activity and the clinical status. Fifty three patients with acute pancreatitis were studied; 17 with haemorrhagic pancreatitis and 36 with a mild form of the disease. S-phospholipase A2 activity increased significantly (p less than 0.05) in patients with fatal pancreatitis but not in those with mild disease. Phospholipase A2 concentrations were below 10 nmol FFA/ml min in mild, while they rose to 20-40 nmol FFA/ml min in haemorrhagic pancreatitis. In fatal cases very high (up to 50-60 nmol FFA/ml min) serum phospholipase A2 concentrations were recorded. The increase in CRP was greater in the patients with severe pancreatitis. One day after admission mean CRP was 280 mg/l in patients with haemorrhagic and 45 mg/l in those with the mild pancreatitis (p less than 0.001). High CRP values also correlated with the prognostic signs indicative of severe pancreatitis. CRP and S-phospholipase A2 determinations are valuable in the early assessment of the severity of acute pancreatitis, but the CRP assay is much easier to include in hospital routine.

Full text

PDF
764

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Coombes R. C., Powles T. J., Gazet J. C., Ford H. T., Sloane J. P., Laurence D. J., Neville A. M. Biochemical markers in human breast cancer. Lancet. 1977 Jan 15;1(8003):132–134. doi: 10.1016/s0140-6736(77)91719-6. [DOI] [PubMed] [Google Scholar]
  2. Crockson R. A., Payne C. J., Ratcliff A. P., Soothill J. F. Time sequence of acute phase reactive proteins following surgical trauma. Clin Chim Acta. 1966 Oct;14(4):435–441. doi: 10.1016/0009-8981(66)90030-1. [DOI] [PubMed] [Google Scholar]
  3. Fischer C. L., Gill C., Forrester M. G., Nakamura R. Quantitation of "acute-phase proteins" postoperatively. Value in detection and monitoring of complications. Am J Clin Pathol. 1976 Nov;66(5):840–846. doi: 10.1093/ajcp/66.5.840. [DOI] [PubMed] [Google Scholar]
  4. Ghoneim A. T., McGoldrick J., Ionescu M. I. Serial C-reactive protein measurements in infective complications following cardiac operation: evaluation and use in monitoring response to therapy. Ann Thorac Surg. 1982 Aug;34(2):166–175. doi: 10.1016/s0003-4975(10)60878-8. [DOI] [PubMed] [Google Scholar]
  5. Gjone E., Ofstad E., Marton P. F., Amundsen E. Phospholipase activity in pancreatic exudate in experimental acute pancreatitis. Scand J Gastroenterol. 1967;2(3):181–185. doi: 10.3109/00365526709180066. [DOI] [PubMed] [Google Scholar]
  6. HEDLUND P. Clinical and experimental studies on C-reactive protein (acute phase protein). Acta Med Scand Suppl. 1961;361:1–71. [PubMed] [Google Scholar]
  7. Imrie C. W., Benjamin I. S., Ferguson J. C., McKay A. J., Mackenzie I., O'Neill J., Blumgart L. H. A single-centre double-blind trial of Trasylol therapy in primary acute pancreatitis. Br J Surg. 1978 May;65(5):337–341. doi: 10.1002/bjs.1800650514. [DOI] [PubMed] [Google Scholar]
  8. Jacobs M. L., Daggett W. M., Civette J. M., Vasu M. A., Lawson D. W., Warshaw A. L., Nardi G. L., Bartlett M. K. Acute pancreatitis: analysis of factors influencing survival. Ann Surg. 1977 Jan;185(1):43–51. doi: 10.1097/00000658-197701000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kauste A., Höckerstedt K., Ahonen J., Tervaskari H. Peritoneal lavage as a primary treatment in acute fulminant pancreatitis. Surg Gynecol Obstet. 1983 Apr;156(4):458–463. [PubMed] [Google Scholar]
  10. Kivilaakso E., Fräki O., Nikki P., Lempinen M. Resection of the pancreas for acute fulminant pancreatitis. Surg Gynecol Obstet. 1981 Apr;152(4):493–498. [PubMed] [Google Scholar]
  11. Kivilaakso E., Lempinen M., Mäkeläinen A., Nikki P., Schröder T. Pancreatic resection versus peritoneal lavation for acute fulminant pancreatitis. A randomized prospective study. Ann Surg. 1984 Apr;199(4):426–431. doi: 10.1097/00000658-198404000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kushner I., Gewurz H., Benson M. D. C-reactive protein and the acute-phase response. J Lab Clin Med. 1981 Jun;97(6):739–749. [PubMed] [Google Scholar]
  13. McMahon M. J., Bowen M., Mayer A. D., Cooper E. H. Relation of alpha 2-macroglobulin and other antiproteases to the clinical features of acute pancreatitis. Am J Surg. 1984 Jan;147(1):164–170. doi: 10.1016/0002-9610(84)90052-7. [DOI] [PubMed] [Google Scholar]
  14. McMahon M. J., Playforth M. J., Pickford I. R. A compaative study of methods for the prediction of severity of attacks of acute pancreatitis. Br J Surg. 1980 Jan;67(1):22–25. doi: 10.1002/bjs.1800670107. [DOI] [PubMed] [Google Scholar]
  15. Pellegrini C. A. The treatment of acute pancreatitis: a continuing challenge. N Engl J Med. 1985 Feb 14;312(7):436–438. doi: 10.1056/NEJM198502143120709. [DOI] [PubMed] [Google Scholar]
  16. Pepys M. B. C-reactive protein fifty years on. Lancet. 1981 Mar 21;1(8221):653–657. doi: 10.1016/s0140-6736(81)91565-8. [DOI] [PubMed] [Google Scholar]
  17. Puolakkainen P., Lempinen M., Schröder T. Fatal pancreatitis. A study of 64 consecutive cases. Acta Chir Scand. 1986 May;152:379–383. [PubMed] [Google Scholar]
  18. Ranson J. H., Rifkind K. M., Roses D. F., Fink S. D., Eng K., Spencer F. C. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974 Jul;139(1):69–81. [PubMed] [Google Scholar]
  19. Saxstad J., Nilsson L. A., Hanson L. A. C-reactive protein in serum from infants as determined with immunodiffusion techniques. II. Infants with various infections. Acta Paediatr Scand. 1970 Nov;59(6):676–680. doi: 10.1111/j.1651-2227.1970.tb17704.x. [DOI] [PubMed] [Google Scholar]
  20. Schmidt H., Creutzfeldt W. The possible role of phospholipase A in the pathogenesis of acute pancreatitis. Scand J Gastroenterol. 1969;4(1):39–48. doi: 10.3109/00365526909180149. [DOI] [PubMed] [Google Scholar]
  21. Schröder T., Kivilaakso E., Kinnunen P. K., Lempinen M. Serum phospholipase A2 in human acute pancreatitis. Scand J Gastroenterol. 1980;15(5):633–636. doi: 10.3109/00365528009182227. [DOI] [PubMed] [Google Scholar]
  22. Schröder T., Kivisaari L., Standertskjöld-Nordenstam C. G., Somer K., Kivilaakso E., Lempinen M. The clinical significance of contrast enhanced computed tomography in acute pancreatitis. Ann Chir Gynaecol. 1984;73(5):268–272. [PubMed] [Google Scholar]
  23. ZIEVE L., VOGEL W. C. Measurement of lecithinase A in serum and other body fluids. J Lab Clin Med. 1961 Apr;57:586–599. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES