The Use of Urinary Amylase Levels in the Diagnosis of Acute Pancreatitis
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 5029-5038
Abstract
Background:Acute pancreatitis is a relatively common but potentially fatal disease seenin surgical practise. Clinical examination, laboratory investigations, and imaging
techniques are used to make a diagnosis of the disease. Patients usually present with
severe pain in the epigastric region that radiates to the back. Serum levels of amylase
and lipase that are more than three times the normal value usually indicate acute
pancreatic inflammation. When clinical and laboratory investigations fail to diagnose
the disease despite a strong suspicion of acute pancreatitis, radiological investigations
are used to make a diagnosis. Urinary clearance of pancreatic enzymes from the
circulation increases in acute pancreatitis. This is a study that will use urinary amylase
levels to diagnose acute pancreatitis in a non-invasive manner. Objectives: To diagnose
acute pancreatitis using urine amylase levels in conjunction with other specific tests
such as serum lipase and abdominal ultrasound, and to demonstrate that urine amylase
can be used to diagnose acute pancreatitis.
Materials and Methods: It is a case control study with 40 patients diagnosed with acute
pancreatitis and 40 patients admitted with other diagnoses. Patients admitted to Princes
Esra Hospital between November 2019 and May 2021 were chosen as cases and
controls. Serum amylase, serum lipase, and urinary amylase levels were measured in
both the case and control groups. After comparing serum amylase, serum lipase, and
urinary amylase levels in cases and controls, the sensitivity and specificity of these
enzymes were determined.The authors concluded that serum amylase had the highest
sensitivity (100 percent) and serum lipase had the highest specificity (100 percent) after
analysing serum amylase, serum lipase, and urinary amylase results in both cases and
controls (95 percent). Urine amylase's sensitivity and specificity were found to be
98.33% and 95%, respectively. The area under the curve for serum amylase, serum
lipase, and urinary amylase was found to be 0.987, 0.995, and 0.935, respectively, using
ROC curve analysis.
Conclusion: Because serum amylase, serum lipase, and urinary amylase have
comparable sensitivity and specificity, as well as comparable areas under the curve on
ROC analysis for the diagnosis of acute pancreatitis, the authors conclude that urinary
amylase can be used in the diagnosis of acute pancreatitis.
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