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Lipase

Pancreas
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Report in 4Hrs

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No Fasting Required

Details

Serum lipase levels are used to diagnose and monitor acute pancreatitis.

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Lipase Test Information Guide

  • Why is it done?
    • Measures the enzyme lipase, which is primarily produced by the pancreas and, to a lesser extent, by salivary glands and other tissues
    • Primary indication: Diagnose and monitor acute pancreatitis, a potentially serious inflammation of the pancreas
    • Evaluate for chronic pancreatitis and pancreatic disorders
    • Assess abdominal pain and evaluate acute abdomen presentations
    • Typical timing: Ordered when patients present with symptoms suggestive of pancreatic involvement, such as severe upper abdominal pain, elevated amylase levels, or suspected gallstone-related complications
  • Normal Range
    • Normal reference range: 30-110 U/L (units per liter), though ranges may vary slightly between laboratories
    • Some laboratories report ranges of 0-160 U/L depending on methodology and patient population
    • Units of measurement: U/L (International Units per Liter)
    • Normal results: Lipase levels within the reference range typically indicate no acute pancreatic disease; however, mild elevations may occur in asymptomatic individuals
    • Elevated results: Levels greater than 110 U/L warrant further investigation; marked elevations (>1000 U/L) are highly suggestive of acute pancreatitis
    • Borderline values (110-150 U/L): May require repeat testing and clinical correlation with symptoms and other laboratory findings
  • Interpretation
    • Mild elevation (110-300 U/L): May indicate early acute pancreatitis, chronic pancreatitis, or other pancreatic conditions; requires clinical evaluation
    • Moderate elevation (300-1000 U/L): Strongly suggests acute pancreatitis, particularly when combined with elevated amylase and clinical symptoms
    • Marked elevation (>1000 U/L): Highly diagnostic of acute pancreatitis; may also occur in severe chronic pancreatitis or pancreatic malignancy
    • Progressive elevation with repeat testing: Indicates worsening pancreatic inflammation; gradual decline suggests improving status
    • Factors affecting readings: Medications (corticosteroids, azathioprine, valproic acid), renal disease, salivary gland disorders, bowel perforation, and intestinal infarction can elevate lipase levels
    • Lipase is more pancreas-specific and remains elevated longer than amylase; typically rises within 4-8 hours of pancreatitis onset and peaks at 24-48 hours
    • Clinical correlation is essential; diagnosis of acute pancreatitis requires lipase elevation plus characteristic symptoms and imaging findings
  • Associated Organs
    • Primary organ: Pancreas (endocrine and exocrine functions affected)
    • Secondary organs: Liver, biliary system, and intestines (interconnected via shared ductal system)
    • Conditions commonly diagnosed: Acute pancreatitis (gallstone-induced, alcohol-related, hypertriglyceridemia-induced), chronic pancreatitis, pancreatic cancer, cystic fibrosis
    • Associated complications: Pancreatic insufficiency, diabetes mellitus (from beta cell damage), malabsorption, pancreatic necrosis, sepsis, organ failure, and systemic inflammatory response syndrome (SIRS)
    • Other conditions with elevated lipase: Renal disease, salivary gland inflammation, inflammatory bowel disease, intestinal perforation, and ectopic pregnancy
    • Potential risks: Severe acute pancreatitis can lead to acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), acute kidney injury, and mortality if untreated
  • Follow-up Tests
    • Serum amylase: Complementary enzyme that confirms pancreatic origin of inflammation; more specific for salivary glands but helps differentiate pancreatic causes
    • Liver function tests (ALT, AST, bilirubin, alkaline phosphatase): Assess for biliary obstruction and liver involvement in gallstone-induced pancreatitis
    • Glucose and hemoglobin A1c: Monitor for pancreatic-induced hyperglycemia and diabetes development
    • Triglycerides and cholesterol: Evaluate hypertriglyceridemia as a potential pancreatitis etiology
    • Imaging studies: Abdominal ultrasound (assess gallstones and pancreatic edema), CT scan (evaluate severity of pancreatitis, necrosis, complications), MRCP (biliary obstruction assessment)
    • Pancreatic imaging (CT/MRI): Recommended when acute pancreatitis is diagnosed to assess severity and guide treatment
    • Complete blood count (CBC): Assess for hemoconcentration and infection markers
    • Calcium level: Low calcium indicates severe pancreatitis with worse prognosis
    • Monitoring frequency: Repeat lipase testing in 24-48 hours to track trend; additional testing based on clinical response and complications
  • Fasting Required?
    • Fasting required: No - lipase can be measured in both fasting and non-fasting states
    • No special fasting duration required: The test can be performed at any time of day without dietary preparation
    • Medications to consider: Continue regular medications as directed; inform healthcare provider of current medications, particularly corticosteroids, azathioprine, and valproic acid, which can affect results
    • Patient preparation: No special preparation needed; routine blood draw procedure applies; arrive on time for appointment
    • Additional instructions: Inform phlebotomist or physician of current symptoms; note that lipase can be drawn as part of a comprehensive metabolic panel that may require fasting depending on additional tests ordered

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