What is Most sensitive and specific for acute pancreatitis amongst the following is: September 2008 and explain in detail?
Ans. C: S.lipase Serum markers for diagnosis of acute pancreatitis: Alanine transaminase-Associated with gallstone pancreatitis; three fold elevation or greater in the presence of acute pancreatitis has a positive predictive value of 95 percent in diagnosing acute gallstone pancreatitis Amylase Most accurate when at least twice the upper limit of normal; amylase levels and sensitivity decrease with time from onset of symptoms C-reactive protein Late marker; high levels associated with pancreatic necrosis Lipase Increased sensitivity in alcohol-induced pancreatitis; more specific and sensitive than amylase for detecting acute pancreatitis Phospholipase A2 Associated with development of pancreatic necrosis and pulmonary failure Procalcitonin Early detection of severity; high concentrations in infected necrosis Trypsinogen activation peptide Early marker for acute pancreatitis and close correlation to severity