The diagnosis of acute pancreatitis: enhanced sensitivity from an ELISA assay of lipase.

An enzyme linked immunosorbent assay (ELISA) for human pancreatic lipase was compared, for diagnostic sensitivity, to a chromogenic assay of total plasma amylase in 37 patients with acute pancreatitis. Data from patients were related to a control group of 38 patients with gastrointestinal disease but without pancreatic diseases. During the first 24 hours of admission, lipase was elevated 131 standard deviations (SD) above the mean of the control range compared to 25 SD for amylase (p less than 0.001). When amylase fell to within the control range (less than 531 iu/l) lipase was still elevated at a mean of 11 SD above the control mean. In patients followed for longer, lipase usually remained above normal for at least ten days, whereas amylase lay within 1 SD of the mean of the control samples in most plasma samples after 4 days. These data show that lipase is considerably more sensitive than total amylase for the diagnosis of acute pancreatitis.