Utility of Lipase for Diagnosis of Acute Pancreatitis

Information for Clinicians

Clinical Biochemistry Department

Utility of Lipase for Diagnosis of Acute Pancreatitis

Overview From December 2020, serum lipase replaces amylase testing at the RUH for use in diagnosis of acute pancreatitis. Lipase is preferable to amylase because of its increased sensitivity (Lipase sensitivity 64-100% cf amylase 50-78%), particularly in alcohol induced pancreatitis due to the longer half-life giving an increased window of diagnosis. It is also considered a more specific test than amylase although it can also be raised in non-specific causes such as renal insufficiency, DKA, and other intra-abdominal pathology. The normal range for lipase is 13-60 IU/L.

Diagnosis of Acute Pancreatitis is support by 2 of the following: Characteristic clinical features

(acute onset persistent, severe, epigastric pain radiating to the back) Elevated Lipase (typically 3x ULN (180 IU/L))

(lipase increases 3-6 hours post onset, peaks at 24 hours and reduces gradually over 14 days) Characteristic findings of acute pancreatitis on imaging

Note that in the community if pancreatitis is suspected admission should not be delayed in order to perform a diagnostic test.

The following interpretative advice is appended to reports:

Lipase (IU/L)

Interpretation

>60 - ................
................

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