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Query: UMLS:C0000737 (
abdominal pain
)
31,184
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Acute pancreatitis was induced in 6 cats by infusion of oleic acid into the pancreatic duct. Clinical changes included fever, tachycardia, and variable degrees of
abdominal pain
; vomiting occurred rarely, and diarrhea was not noted. Serum
lipase
activities were significantly increased through the 4th day after the surgical operation, although amylase activities were significantly decreased during most of the acute phase. Serum calcium and phosphate concentrations were decreased significantly on the 4th day after surgical operation. Hematologic alterations included normocytic, normochromic, responsive anemias, but changes in WBC values were not statistically significant. Evidence of exocrine pancreatic insufficiency after induction of acute pancreatitis was not demonstrated in any cats during the study. The results of this study indicate that increases in serum
lipase
activity are the most consistent and earliest indicators of acute pancreatitis in cats, but that more sensitive methods of laboratory evaluation should be sought.
...
PMID:Clinical and pathologic changes in experimentally induced acute pancreatitis in cats. 242 50
Acute alcoholic pancreatitis is a clinical diagnosis made in patients who have acute upper
abdominal pain
, emesis, and hyperamylasemia soon after ingesting alcohol. We sought to determine whether the clinical diagnosis of pancreatitis was supported by elevated serum levels of pancreatic isoamylase, currently the most specific test for pancreatitis. Serum
lipase
levels and urinary amylase/creatinine clearance ratios were examined for comparison with pancreatic isoamylase concentrations. Potential sources for salivary isoamylasemia were explored with technetium scans of the parotid glands. Of 19 patients with a clinical diagnosis of alcoholic pancreatitis, 16 had elevated levels of pancreatic isoamylase, and 17 had salivary hyperamylasemia. The diagnostic specificity of the serum
lipase
level or the urinary amylase/creatinine clearance ratio was excellent compared to that of the pancreatic isoamylase level. Three patients had elevated levels of salivary isoamylase only. Scans of the parotid glands in the study group revealed significantly higher uptake values than scans in nonalcoholic control subjects, suggesting one possible source of elevated levels of salivary isoamylase.
...
PMID:Alcoholic pancreatitis and parotitis: utility of lipase and urinary amylase clearance determinations. 242 37
We report a case of fatal pancreatitis heralded by the presence of cutaneous panniculitis without
abdominal pain
or other stigmata of the disease. Although cutaneous fat necrosis has been associated with pancreatitis, it is unusual as the presenting complaint of this relatively common disease. In vitro evidence suggests that human pancreatic amylase or
lipase
alone is not responsible for the observed panniculitis.
...
PMID:Fatal pancreatitis presenting with subcutaneous fat necrosis. Evidence that lipase and amylase alone do not induce lipocyte necrosis. 244 10
Macroamylasemia is a condition characterized by a serum amylase activity increase due to complex macromolecules whose large size prevents its urinary excretion. It cannot be consistently correlated with any particular disease state, and should be regarded as a benign chemical derangement. The major clinical importance of macroamylasemia is the confusion of this condition with other causes of hyperamylasemia and its prevalence in the population, comprised between 1 and 2%. Macroamylasemia should be considered in any patient with elevated levels of serum amylase activity whose serum
lipase
and urine amylase levels are normal, in the face of unimpaired renal function. Confirmation rests on the demonstration of a macromolecular amylase component in the serum by means of chromatography, ultracentrifugation and electrophoresis. In this report, we, describe a patient with chronic liver disease caused by alcohol, occasional
abdominal pain
and persistent hyperamylasemia, though to be due to pancreatitis, but subsequently shown to be due to a macroamylase.
...
PMID:[Macroamylasemia or pancreatitis? A diagnostic problem]. 244 75
One hundred thirty blood samples from 87 patients with renal failure, but without
abdominal pain
, were analyzed for blood urea nitrogen (BUN), creatinine, amylase, p-isoamylase, and
lipase
simultaneously. We found that 74, 78, and 80% of the patients had hyperamylasemia, hyperisoamylasemia, and hyperlipasemia. None had amylase higher than five times the upper limit. A few patients (2.3%) had
lipase
elevated to more than 10 times the upper limit. No significant change of pancreatic enzyme level was noted as a result of hemodialysis, but a significant amount of amylase was removed from the circulation in patients receiving intermittent peritoneal dialysis. Significantly lower pancreatic enzyme levels were observed in patients with less impairment of renal function. We conclude that elevation of pancreatic enzymes in uremic patients is more frequent and more extensive than most articles indicate, and that the extent of increase is related more to renal function than to the modalities of dialysis the patients received.
...
PMID:Pancreatic enzymes in uremic patients with or without dialysis. 245 11
The serum behavior of amylase, pancreatic isoamylase,
lipase
, trypsinogen, and elastase 1 was studied in 145 patients with pancreatic disease and in 66 patients with
abdominal pain
of nonpancreatic origin, for the purpose of evaluating the relative diagnostic utility of their assays. In 34 patients with acute pancreatitis, serum
lipase
, trypsinogen, and elastase 1 were elevated in all 34, pancreatic isoamylase in 33 (97%) and amylase in 30 (88%). Ten of these acute pancreatitis patients were followed sequentially for seven days: the variations in their serum enzyme levels were parallel, although the
lipase
, trypsinogen, and particularly the elastase 1 elevations persisted longer than did those of amylase and pancreatic isoamylase. Among the patients with chronic pancreatitis, either in painful relapse (N = 19) or with pancreatic cysts (N = 15), the respective percentages of enzymes elevations were: 79 and 80% for elastase 1, 68 and 67% for trypsinogen, 63 and 73% for pancreatic isoamylase, 58 and 60% for
lipase
, 53 and 60% for amylase. In the 52 chronic pancreatitis patients studied during clinical remission, serum enzyme behavior varied greatly, and a majority of the assays (60%) were normal; even in the case of severe pancreatic exocrine insufficiency, normal as well as abnormally high and low enzyme values were seen. Highly variable enzyme behavior was also seen in the 40 patients with pancreatic cancer, and elastase I was the most frequently (35%) elevated enzyme in this group as well. Among the patients with
abdominal pain
of nonpancreatic origin, abnormally high enzyme levels were present in percentages ranging from 6% for
lipase
to 21% for trypsinogen.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Role of serum pancreatic enzyme assays in diagnosis of pancreatic disease. 279 21
In a prospective five-year study of 65 consecutive patients with upper
abdominal pain
the Neostigmine Morphine Test (NMT) was applied as a screen for biliary, ampullary, and pancreatic disease. Three facts emerged from this study: 1) the amylase and
lipase
were overly sensitive, but not specific and had only a 10 per cent predictive value for ampullary obstruction; 2) the bilirubin, alkaline phosphatase, and serum glutamic oxaloacetic transaminase (SGOT) were positive in patients with ampullary obstruction if they were postcholecystectomy but not so in patients with an intact gallbladder, which may be explained by the third observation; 3) the gallbladder can compensate for partial ampullary obstruction by dilatation five to ten times and by its ability to absorb 90 per cent of the water content of the bile. The Neostigmine Morphine Test is not a reliable screen for ampullary obstruction and positive findings must be confirmed by other studies.
...
PMID:A second look at the neostigmine morphine test. 247 60
The sensitivity and specificity of five assays used to diagnose acute pancreatitis were studied: two amylase assays; one
lipase
; one trypsinogen; and one pancreatic isoamylase. Thirty-nine patients with acute pancreatitis were compared to 127 controls with
abdominal pain
. Using the upper limit of normal both amylase assays appeared sensitive but somewhat nonspecific (specificities of 88.9% and 86%, respectively). The trypsinogen and pancreatic isoamylase assays were also relatively nonspecific (specificity of 82.8% and 85.1%). Most nonspecific elevations occurred between a one- and twofold elevation of each assay. Lipase, however, maintained excellent specificity (99%) at its upper limit of normal. If the level of best cutoff is used instead (the level that best enhances sensitivity and specificity), the specificities of both amylase assays, as well as the trypsinogen and pancreatic isoamylase assays, exceed 95%. At the best cutoff level, trypsinogen maintains a qualitative advantage in sensitivity over
lipase
or pancreatic isoamylase (97.4% as compared to 86.5% and 84.6%).
...
PMID:Diagnostic assays in acute pancreatitis. A study of sensitivity and specificity. 258 Apr 67
A 12-year-old girl was admitted to our hospital with signs of an acute abdomen with paralytic ileus. The previous and family history were without abnormalities.
Abdominal pain
and vomiting had started two days earlier. On palpation the swollen abdomen was painful and there was an increased tension in the left upper part. The clinical diagnosis of acute pancreatitis was confirmed by an increased serum level of
lipase
(4480 U/l). Clinical chemical investigations further revealed a permanent hypercalcemia in the range of 6.4 to 8.3 mval/l. This, together with concomitantly reduced levels of serum phosphate and a threefold increased level of parathyroid hormone (343 pg/ml, upper limit of reference = 100 pg/ml) were consistent with a hyperparathyroidism. In fact, sonography of the cervical organs revealed a solitary adenoma of the parathyroid glands. After surgery serum levels of calcium returned to normal. Hypercalcemia as a consequence of primary hyperparathyroidism has to be included in the differential diagnosis of acute pancreatitis in childhood.
...
PMID:[Acute pancreatitis as an initial manifestation of hypercalcemia in primary hyperparathyroidism in childhood]. 265 77
We examined 56 French Canadians, aged 1 week to 54 years, from eastern Quebec who were referred to the Laval University Lipid Research Centre and in whom coincidental finding (in 46% of the cases),
abdominal pain
(in 32%) or family screening (in 22%) led to the diagnosis of primary lipoprotein-
lipase
-activity deficiency (familial hyperchylomicronemia). Half of the patients had one or more of the following signs: lipemia retinalis, eruptive xanthomas, splenomegaly and hepatomegaly; the plasma triglyceride concentrations were significantly higher (greater than 40 mmol/L) among these patients than among those without clinical signs (mean 21.7 [standard deviation 13.5] mmol/L). The prevalence rate of this disorder was 30 times higher than the previously published rate and was highest in the counties of Charlevoix and Saguenay-Lac-St-Jean (200 and 100 cases per million respectively) because of the distinct demographic history of these areas. Because of a founder effect an autosomal recessive gene involved in lipoprotein-
lipase
expression or activation has probably been disseminated among this isolated French Canadian population.
...
PMID:Primary lipoprotein-lipase-activity deficiency: clinical investigation of a French Canadian population. 291 62
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