see: [[pancreatitis]], [Hayes' - lipase](x-devonthink-item://07A86322-C804-4B40-9134-1CBB48BD3B33) normal reference range is ~ 0-50 U/L ; varies with laboratory **Causes of elevated lipase** - [[pancreatitis]] (acute or chronic) - pancreatic cancer - pancreatic trauma - pancreatic pseudocyst - minor elevations from: - other intra-abdominal pathologies - [[Bowel obstruction]] - [[Inflammatory Bowel Disease|IBD]] - celiac disease - peritonitis - [[Mesenteric ischaemia]] - renal impairment - drugs - [[DKA]] **Interpretation** - ≥ 3x upper limit of normal generally considered diagnostic pancreatitis, *close to 100% specific* - lipase rises in 4-8 hours, so ==clinical symptoms can precede significant elevation in lipase levels== - peak level of lipase rise does NOT determine disease severity or outcome - lipase remains elevated for up to 8-14 days - in chronic pancreatitis, significant elevations of lipase may not occur in "acute on chronic" flares, as atrophy of the pancreatic parenchyma can result in serum enzyme levels within normal range, even during acute attacks of pain. ; this is more of a clinical diagnosis *disadvantages of lipase as a diagnostic marker for pancreatitis?* - levels may be normal within 4 hours of onset - sensitivity is reduced in hyperlipidaemia - degree of elevation correlates poorly with disease severity