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Repeat Lipase Testing

The American Society of Clinical Pathology recommends measuring lipase for the initial diagnosis of acute pancreatitis, but states that repeat measurements have little value. There is no evidence that the degree of lipase elevation predicts severity or prognosis. The preferred method to assess severity is the use of a validated clinical risk scoring system. The International Association of Pancreatology and American Pancreatic Association guidelines recommend using the systemic inflammatory response syndrome (SIRS) score at admission and 48 hours to determine acute pancreatitis severity.

Repeat testing is indicated only when there are signs of persistent pancreatic or peripancreatic inflammation, pancreatic duct blockage or development of a pseudocyst.

Reisman A, et al. Unnecessary repeat enzyme testing in acute pancreatitis: A teachable moment. JAMA Intern Med, published online March 12, 2018.


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