IL-6, IL-10 and TNF alpha do not improve early detection of post-endoscopic retrograde cholangiopancreatography acute pancreatitis: a prospective cohort study
Por:
Concepcion-Martin, M, Gomez-Oliva, C, Juanes, A, Mora, J, Vidal, S, Diez, X, Torras, X, Sainz, S, Villanueva, C, Farre, A, Guarner-Argente, C, Guarner, C
Publicada:
19 sep 2016
Resumen:
The most reliable indicators for post-ERCP acute pancreatitis are elevated amylase levels and abdominal pain 24 hours after ERCP. As ERCP is often performed on an outpatient basis, earlier diagnosis is important. We aimed to identify early predictors of post-ERCP pancreatitis. We prospectively analyzed IL-6, IL-10, TNF alpha, CRP, amylase and lipase before and 4 hours after ERCP, and studied their association with abdominal pain. We included 510 patients. Post-ERCP pancreatitis occurred in 36 patients (7.1%). IL-6, IL-10, TNF alpha and CRP were not associated with post-ERCP pancreatitis. Levels of amylase and lipase were higher in patients with pancreatitis (522 U/L and 1808 U/L vs. 78 U/L and 61 U/L, respectively; p < 0.001). A cut-off of 218 U/L for amylase (x2.2 ULN) and 355 U/L for lipase (x6 ULN) had a negative predictive value of 99.2% and 99.5%, respectively. Amylase and lipase present a good correlation (Pearson coefficient 0.912). Among 342 (67.1%) patients without abdominal pain at 4 hours, post-ERCP pancreatitis was diagnosed in 8 (2.3%). Only 4 of these patients presented amylase or lipase > 3 ULN. Amylase and lipase were the only markers of post-ERCP pancreatitis 4 hours after the procedure.
Filiaciones:
Concepcion-Martin, M:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Gastroenterol, Barcelona, Spain
Gomez-Oliva, C:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Gastroenterol, Barcelona, Spain
Juanes, A:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Pharmacol, Barcelona, Spain
Mora, J:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Clin Chem, Barcelona, Spain
Vidal, S:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Immunol, Barcelona, Spain
Diez, X:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Gastroenterol, Barcelona, Spain
Torras, X:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Gastroenterol, Barcelona, Spain
Sainz, S:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Gastroenterol, Barcelona, Spain
Villanueva, C:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Gastroenterol, Barcelona, Spain
Inst Carlos III, Ctr Invest Biomed Red Area Temat Enfermedades Hep, Madrid, Spain
Farre, A:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Gastroenterol, Barcelona, Spain
Guarner-Argente, C:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Gastroenterol, Barcelona, Spain
Guarner, C:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Inst Recerca IIB Sant Pau, Dept Gastroenterol, Barcelona, Spain
Inst Carlos III, Ctr Invest Biomed Red Area Temat Enfermedades Hep, Madrid, Spain
Gold, Green Published
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