Serum lipase, C-reactive protein, and interleukin-6 levels in ERCP-induced pancreatitis.
ABSTRACT C-reactive protein (CRP) and interleukin-6 (IL-6) are elevated in acute pancreatitis. Limited studies have evaluated their role in ERCP-induced pancreatitis. The aim of this study was to assess the role of serum lipase, CRP, and IL-6 in ERCP-induced pancreatitis.
Eighty-five patients (62 women, 23 men; mean age 43 years; range 16-85 years) who underwent ERCP were entered in a prospective trial. ERCP-induced pancreatitis was classified as mild, moderate, or severe. Serum levels of lipase, CRP, and IL-6 were measured before ERCP and at 12 to 24 hours and 36 to 48 hours after ERCP.
Mild, moderate, and severe pancreatitis occurred, respectively, in 9, 7, and 4 patients after ERCP. There were significant differences in levels of CRP and IL-6 but not lipase for patients with mild versus moderate and moderate versus severe pancreatitis. The mean CRP levels (mg/dL) at 12 to 24 hours were 0.98 +/- 0.24 in mild pancreatitis, 3.89 +/- 0.32 in moderate pancreatitis, and 12.0 +/- 1.60 in severe pancreatitis. The levels, respectively, at 36 to 48 hours were 1.60 +/- 0.31, 7.60 +/- 0.74, and 25.0 +/- 2.9. The mean IL-6 levels (pg/mL) at 12 to 24 hours were 16.6 +/- 2.06 in mild pancreatitis, 73.0 +/- 15.60 in moderate pancreatitis, and 235.5 +/- 26.31 in severe pancreatitis. The levels at 36 to 48 hours were, respectively, 18.92 +/- 3.28, 100.17 +/- 11.56, and 438.2 +/- 71.50.
Serum CRP and IL-6 levels may be useful early markers for predicting the severity of ERCP-induced pancreatitis.
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ABSTRACT: To study the effect of pentoxifylline and octreotide administration on serum levels of TNF-alpha and IL-6, in patients who underwent endoscopic retrograde cholangiopancreatography (ERCP), whether they developed pancreatitis or not. Out of 590 patients undergoing ERCP, 30 who developed pancreatitis and 25 who did not (controls) were enrolled. Pentoxifylline was given to 23 patients (15 with and eight without pancreatitis) and octreotide to 19 patients (nine with and 10 without pancreatitis, respectively). Thirteen patients did not receive any preventive medication (six with and seven without pancreatitis, respectively). Blood samples were collected at baseline, 6 and 24 h after ERCP. IL-6 increased significantly in patients with pancreatitis at the 6 h (4.2 pg/ml SD: 5.8) and at the 24 h (6.6 pg/ml SD: 9.8) compared with patients without pancreatitis at the 6 h (2.1 pg/ml SD: 3.6) and 24 h (1.9 pg/ml SD: 2.5) (P < 0.01). No significant difference in the values of TNF-alpha and IL-6 obtained among the three study groups in patients with or without pancreatitis was observed. TNF-alpha levels at the 24 h were lower than baseline in patients with pancreatitis who received octreotide (P = 0.04). IL-6 increased in the first 24 h of post-ERCP pancreatitis. Pentoxifylline and octreotide cannot prevent IL-6 elevation but octreotide reduces TNF-alpha levels, which may have an impact on the severity of post-ERCP pancreatitis.European journal of gastroenterology & hepatology 05/2009; 21(5):529-33. · 1.66 Impact Factor
- The American Journal of Gastroenterology 01/2007; 102(7):1541-1542. · 9.21 Impact Factor
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ABSTRACT: Results: EPO was shown to increase leukocyte counts in the early phase (P < 0.05) though the effect diminished in time. It also had an increasing effect on amylase in the early hours (P < 0.005), but the difference between the groups disappeared in the following hours. No effect was demonstrated on serum CRP. Pancreatic tissue revealed moderate degree of pancreatitis in group III sacrificed at 6 hours and in group IV evaluated at 6 and 24 hours. Despite the absence of a difference in the numerical analysis of Spormann scoring (P > 0.05), moderate pancreatitis developed in the group receiving EPO. Conclusions: The results we have obtained demonstrate that more controlled models (employing low rates of sodium taurocholate or edematous pancreatitis) are necessary to better investigate the efficacy of EPO. Bulgular: Erken saatlerde EPO'nun lökosit deerlerini art›rd›¤› (P < 0.05) ancak zaman geçtikçe etkisinin siliklefltii tespit edilmifltir. Amilaz üzerine de erken saatte art›r›c› etki gösterdii (P < 0.005), ilerleyen saatlerde gruplar aras›nda fark kalmad›¤›n› göstermifltir. Serum CRP'si üzerine herhangi bir etkisi ortaya konulamam›flt›r. Pankreas dokusunda, rakamsal olarak 6.saatte sakrifiye edilen III. grupta ve 6. ve 24. saatlerde incelenen IV. gruplarda orta fliddette pankreatite rastlanm›flt›r. Sporman skorlamas›n›n rakamsal analizinde anlaml› farkl›l›k olmamas›na (P > 0,05) karfl›n, ortaya ç›kan orta fliddetteki pankreatit EPO verilen gruplarda oluflmufltur. Sonuç: Lökosit ve amilaz deerlerinde erken saatlerdeki anlaml› farkl›l›k ilerleyen saatlerde belirsizleflmifltir. Histopatolojik olarak modelin yaratt›¤› fliddetli tablo nedeniyle, daha kontrollü pankreatit tablosunda (düflük oranl› Na taurokolat kullan›lan veya ödematöz pankreatit oluflturulan modellerde) EPO'nun etkinlii, ortaya aç›k olarak konabilir. EPO'nun amilaz ve lökosit üzerine etkisi olduu ön görülmekle birlikte, hafif pankreatit tablosunda etki, daha net gözlenebilir.