Pancreatitis

Do you have sudden, unexplained pain in your abdomen?

Order from Ulta Lab Tests pancreatitis tests to check the amylase and lipase enzymes in your bloodstream to detect pancreatitis.

Pancreatitis is a disease that causes inflammation of the pancreas that causes severe abdominal pain, and can lead to death. It can be acute or chronic, and it's often caused by gallstones or excessive alcohol use. It usually occurs when there's a build-up of fluid in the pancreas, which could mean that your body has been storing too much alcohol or sugar. It's important to get tested for pancreatitis if you are experiencing any of these symptoms. Early detection is key to preventing pancreatic cancer, so if you think you might have this condition, get tested today!

In addition to abdominal pain, symptoms can include nausea and vomiting, fever, rapid heart rate, and low blood pressure. The most common cause of pancreatitis is gallstones or excessive alcohol use. However, there are other possible causes as well including trauma to the abdomen (such as from an automobile accident), infections in the pancreas or surrounding areas (such as pneumonia), medications such as steroids or valproic acid (Depakote) used for seizures or bipolar disorder, certain cancers including lymphoma and leukemia, autoimmune diseases such as lupus erythematosus and rheumatoid arthritis that affect your immune system's ability to fight off infection; inherited disorders that can damage your pancreas over time; obesity; diabetes mellitus type 2; hypertriglyceridemia which means high levels of triglycerides in your bloodstream; hypothyroidism which means low thyroid hormone production by your thyroid gland leading to weight gain even though you eat little food because you feel full quickly after eating small amounts of food due to slowed metabolism caused by lower thyroid function ; chronic kidney disease ; cirrhosis which means scarring of liver tissue from long-term damage due to hepatitis B virus , hepatitis C virus , alcoholism , nonalcoholic fatty liver disease , hemochromatosis which means excess iron storage in organs throughout the body causing organ.

If you want to learn more about the condition of pancreatitis and the lab tests that can help you, click on the title of the article below.

Pancreatitis and Lab Testing - What You Need to Know

Do you have an elevated amylase level?

Amylase is an enzyme produced by your salivary glands, stomach, small intestine, and pancreas. When there's inflammation in your body or damage to your pancreas, it releases more enzymes into the bloodstream than usual. This test measures how much amylase is in your blood at one time so doctors can determine whether or not you have pancreatitis. If they find high levels of amylase in your blood sample, then they will likely order a lipase test as well because this enzyme can be found together with amylase during pancreatic diseases such as acute pancreatitis and chronic pancreatitis (pancreatic cancer). 

The lipase test measures how much lipase is present in the bloodstream when there may be problems with the pancreas or digestive system causing fat malabsorption issues like steatorrhea (fatty stools) due to lack of bile flow from blocked bile ducts caused by gallstones or tumor compression on the common bile duct resulting in jaundice (yellowing skin/eyes), pale stools and dark urine coloration; all signs associated with obstructive jaundice syndrome

The Pancreatic Cancer Research Foundation recommends routine testing for pancreatitis in people with symptoms, including abdominal pain and weight loss. The best way to prevent pancreatitis is through early diagnosis and treatment. Our tests will help you determine if you have this condition so you can obtain the proper care for yourself before it becomes worse! 

Ulta Lab Tests is dedicated to assisting you in understanding your health! We provide discounted lab tests online 24 hours a day, seven days a week, with Quest Diagnostics results delivered in 24 to 48 hours for most tests. We also have 2,000 lab tests and 2100 testing sites around the country! 

Order your blood tests to detect, diagnose and monitor pancreatitis from the selection below today and take charge of your health!


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The major sources of amylase are the pancreas and the salivary glands. The most common cause of elevation of serum amylase is inflammation of the pancreas (pancreatitis). In acute pancreatitis, serum amylase begins to rise within 6-24 hours, remains elevated for a few days and returns to normal in 3-7 days. Other causes of elevated serum amylase are inflammation of salivary glands (mumps), biliary tract disease and bowel obstruction. Elevated serum amylase can also be seen with drugs (e.g., morphine) which constrict the pancreatic duct sphincter preventing excretion of amylase into the intestine.

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Confirmatory evidence for diagnosis of pancreatitis

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Lipid Panel includes: Total Cholesterol, HDL Cholesterol, Triglycerides, LDL-Cholesterol (calculated), Cholesterol/HDL Ratio (calculated), Non-HDL Cholesterol (calculated)Total cholesterol —this test measures all of the cholesterol in all the lipoprotein particles.High-density lipoprotein cholesterol (HDL-C) — measures the cholesterol in HDL particles; often called "good cholesterol" because it removes excess cholesterol and carries it to the liver for removal.Direct LDL - Low-density lipoprotein cholesterol (LDL-C) — calculates the cholesterol in LDL particles; often called "bad cholesterol" because it deposits excess cholesterol in walls of blood vessels, which can contribute to atherosclerosis. Usually, the amount of LDL cholesterol (LDL-C) is calculated using the results of total cholesterol, HDL-C, and triglycerides.Triglycerides — measures all the triglycerides in all the lipoprotein particles; most is in the very low-density lipoproteins (VLDL).


A lipid panel includes:Total cholesterol —this test measures all of the cholesterol in all the lipoprotein particles.High-density lipoprotein cholesterol (HDL-C) — measures the cholesterol in HDL particles; often called "good cholesterol" because it removes excess cholesterol and carries it to the liver for removal.Low-density lipoprotein cholesterol (LDL-C) — calculates the cholesterol in LDL particles; often called "bad cholesterol" because it deposits excess cholesterol in walls of blood vessels, which can contribute to atherosclerosis. Usually, the amount of LDL cholesterol (LDL-C) is calculated using the results of total cholesterol, HDL-C, and triglycerides.Triglycerides — measures all the triglycerides in all the lipoprotein particles; most is in the very low-density lipoproteins (VLDL).Very low-density lipoprotein cholesterol (VLDL-C) — calculated from triglycerides/5; this formula is based on the typical composition of VLDL particles.Non-HDL-C — calculated from total cholesterol minus HDL-C.Cholesterol/HDL ratio — calculated ratio of total cholesterol to HDL-C.


A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Comprehensive Metabolic Panel


Increased CRP levels are found in inflammatory conditions including: bacterial infection, rheumatic fever, active arthritis, myocardial infarction, malignancies and in the post-operative state. This test cannot detect the relatively small elevations of CRP that are associated with increased cardiovascular risk.

Antinuclear antibodies are associated with rheumatic diseases including Systemic Lupus Erythematous (SLE), mixed connective tissue disease, Sjogren's syndrome, scleroderma, polymyositis, CREST syndrome, and neurologic SLE. 

Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge.


C3a desArg is a cleavage product of C3 complement component activation. Elevated levels of C3a have been reported in patients with acute lyme disease, acute pancreatitis, systemic lupus erythematosus, and adult respiratory distress syndrome.


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Serum calcium is involved in the regulation of neuromuscular and enzyme activity, bone metabolism and blood coagulation. Calcium blood levels are controlled by a complex interaction of parathyroid hormone, vitamin D, calcitonin and adrenal cortical steroids. Calcium measurements are useful in the diagnosis of parathyroid disease, some bone disorders and chronic renal disease. A low level of calcium may result in tetany.


Epstein-Barr Virus (EBV) Antibody Panel

Includes: Epstein-Barr Virus VCA Antibody (IgM), Epstein-Barr Virus VCA Antibody (IgG), Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

Clinical Significance: Primary infection by EBV causes infectious mononucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders including tumors. VCA-IgM is typically detectable at clinical presentation, then declines to undetectable levels within a month in young children and within 3 months in other individuals. VCA-IgG is typically detectable at clinical presentation, and persists for life. EBNA IgG typically appears during convalescence (3-4 months after clinical presentation) and remains detectable for life.

EBV-VCA IgG/IgM (viral capsid antigen): A positive IgG means you’ve had or currently have the infection; A positive IgM means the virus has been reactivated.

EBV-EBNA IgG (nuclear antigen): A positive test result is usually associated with past infections.

Reference Range(s)

Epstein-Barr Virus VCA Antibody (IgM)

U/mLInterpretation

  • <36.00 Negative
  • 36.00-43.99Equivocal
  • >43.99Positive


Epstein-Barr Virus VCA Antibody (IgG)

U/mLInterpretation

  • <18.00 Negative
  • 18.00-21.99Equivocal
  • >21.99Positive


Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

U/mLInterpretation

  • <18.00 Negative
  • 18.00-21.99Equivocal
  • >21.99Positive

Alternative Name(s)

EBV Comprehensive,Infectious Mononucleosis Panel

 


Epstein-Barr Virus DNA, Real-Time PCR is useful in assessing active disease. Central nervous system infections can be diagnosed with CSF specimens.

Epstein-Barr Virus Nuclear Antigen (EBNA) Antibody (IgG)

Primary infection by EBV causes infectious mononucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders including tumors. VCA-IgG is typically detectable at clinical presentation, and persists for life. Absence of VCA-IgG usually indicates the patient is susceptible to EBV infection.

Primary infection by EBV causes infectious mononucleosis, usually a self-limiting disease in children and young adults. Infection with EBV can cause lymphoproliferative disorders including tumors. VCA-IgM is typically detectable at clinical presentation, then declines to undetectable levels within a month in young children and within 3 months in other individuals.

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Serum glucose levels may be abnormally high (hyperglycemia) or abnormally low (hypoglycemia). Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolic disorders including diabetes mellitus, idiopathic hypoglycemia, and pancreatic islet cell neoplasm.

MMR (IgG) Panel (Measles, Mumps, Rubella) Titers - Includes Measles Antibody (IgG), Mumps Antibody (IgG), Rubella Immune Status

This panel provides presumptive evidence of immunity to measles, mumps, and rubella for purposes of routine vaccination, for students at post-high school educational institutions, and for international travelers.

 


Mumps is an acute, usually self-limited systemic illness characterized by parotidites, high fever and fatigue. One third of infections are asymptomatic. A live attenuated vaccine is available. The mumps EIA IgG antibody test is sufficiently sensitive to establish immune status of the patient.

Pancreatic Elastase-1

Collection Instructions - Collect undiluted feces in clean, dry, sterile leak-proof container.

Clinical Significance

The Elastase-1 is a quantitative enzyme linked immunosorbent assay for measuring concentrations of elastase-1 in feces as an aid in diagnosis of the exocrine pancreatic function.

 

Serum triglyceride analysis has proven useful in the diagnosis and treatment of patients with diabetes mellitus, nephrosis, liver obstruction, other diseases involving lipid metabolism, and various endocrine disorders. In conjunction with high density lipoprotein and total serum cholesterol, a triglyceride determination provides valuable information for the assessment of coronary heart disease risk.


Pancreatitis involves the inflammation of the pancreas. Chronic pancreatitis is a long-term condition, while acute pancreatitis occurs for a short duration.

The pancreas is located below the liver and behind the stomach. It has a narrow, flat shape, and is around 6 inches long. The gland is split into three sections: the head, the tail, and the middle. The head section is connected to the start of the duodenum (small intestine).

The pancreas produces bicarbonate and digestive enzymes that are transported into the large pancreatic duct by small tubes. The large duct moves the bicarbonate and digestive enzymes from the tail section of the pancreas to the head section and subsequently into the small intestine.

Another duct running through the pancreas’s head section is the bile duct, which carries bile from the gallbladder and liver into the duodenum. The pancreatic duct and the bile duct converge before entering the small intestine through the same duodenum opening.

The pancreas is comprised of two distinct types of tissues that each perform special functions:

Exocrine Tissues

The exocrine pancreas manufactures, stores, and outputs strong digestive enzymes that break down carbohydrates, proteins, and fats in the duodenum. The enzymes are transported to the small intestine in an inactive state, ready to be activated as required. In addition to potent digestive enzymes, exocrine tissues also produce bicarbonate. Bicarbonate is used to neutralize stomach acid to allows for digestive enzyme activation.

Endocrine Tissues

The endocrine pancreas makes and releases hormones, including glucagon and insulin. Glucagon and insulin are used to regulate glucose levels in the blood and maintain efficient transportation of sugar into the cells that require it for energy.

Pancreatitis occurs when digestive enzymes become activated inside the pancreas. The activation of such enzymes causes irritation and damage to pancreatic tissues, leading to swelling and inflammation.

In the case of acute pancreatitis, the onset of inflammation is rapid but only lasts a couple to days.

The causes of pancreatitis are long-term alcohol abuse and gallstones that clog the pancreatic duct. Severe attacks can necessitate a lengthy stay in a hospital so that serious complications can be treated, and the condition can be monitored. With modern treatment methods, mild cases can often be cured in a few days. Furthermore, during mild attacks, the pancreas is likely to return to normal functioning after healing.

Recurrent acute pancreatitis attacks can lead to chronic pancreatitis, which is long-lasting pancreas inflammation and swelling. The leading cause of chronic pancreatitis is long-term alcohol abuse. Those who smoke cigarettes are also at an increased risk of developing the condition.

Chronic pancreatitis can result in the development of scar tissue inside the pancreas, which can impair its functionality. A malfunctioning pancreas can cause diabetes and digestive problems.

Pancreatitis is more common in males than in females. Cases of the condition are also becoming more numerous in the USA, however, the reasons for the increasing number of cases are unclear. Around 2750,000 individuals are hospitalized for acute pancreatitis every year. Cases of chronic pancreatitis are less common, with hospitalization numbers of around 86,000 individuals each year.

Causes of Pancreatitis

As previously mentioned, the main causes of the condition are long-term alcohol abuse and gallstones. Additional causes can include:

  • Viral infections, including Epstein-Barr virus and mumps
  • Pancreatic cancer
  • Injury to the gland organ
  • Use of pharmaceutical medications like estrogen pills and valproic acid
  • High blood calcium levels or triglyceride levels
  • Cystic fibrosis
  • Carrier of the gene responsible for cystic fibrosis
  • Certain autoimmune conditions
  • Inherited pancreas defects

In some cases, the exact cause of acute or chronic pancreatitis remains unclear.

Pancreatitis can be prevalent in families, and several genes have been identified as being associated with an increased risk of developing the condition.

Signs & Symptoms

1. Acute 

Here are some of the most common acute pancreatitis signs and symptoms:

  • Fever
  • Nausea
  • Vomiting
  • Severe upper abdominal pain. The pain often worsens when lying flat or after eating and can radiate to the spine.
  • Racing pulse
  • Abdominal tenderness and swelling

An attack of acute pancreatitis causes local inflammation, hemorrhage, and swelling of the pancreas, which typically disappears after treatment, leaving no permanent damage. However, sometimes such an attack can be very severe and lead to complications, such as:

  • Kidney failure
  • Infection
  • Necrosis (tissue death)
  • Trouble breathing
  • Pancreatic pseudocysts (sacs full of dead tissue and fluid, which often become infected)
  • Low blood pressure

If you notice any of the signs and symptoms of acute pancreatitis, it’s vital that you contact a healthcare professional as the severity of symptoms does not always correspond to the amount of damage occurring. Some of the signs and symptoms of the condition can also be signs of a different medical condition that requires different treatment methods.

Swift diagnosis and treatment of acute pancreatitis are essential for preventing complications, limiting infection, and reducing inflammation. Repeated attacks of acute pancreatitis can result in chronic pancreatitis.

2. Chronic 

Individuals suffering from chronic pancreatitis might experience recurring attacks that have symptoms similar to a bout of acute pancreatitis. As the condition progresses, the frequency of the attacks often increases. Pain resulting from chronic pancreatitis can be very severe and intermittent or continuous. The pain often worsens after consuming food or drinking, in particular alcoholic beverages.

Over time, chronic pancreatitis can lead to the gland organ becoming scarred and unable to manufacture digestive enzymes properly. This can result in:

  • Malnutrition
  • Weight loss
  • Pancreatic insufficiency
  • Pancreatic pseudocysts (sacs full of dead tissue and fluid, which often become infected)
  • Ascites (fluid buildup in the abdomen)
  • Fatty, foul-smelling stools
  • Once the cells in the pancreas that make insulin are severely damaged, diabetes can develop

Diagnosis

The diagnosis of pancreatitis requires a physical exam, medical history check, imaging tests, and blood tests. Two out of the following three criteria must be met for an acute pancreatitis diagnosis:

1. “Characteristic” imaging results

2. Pain in the abdominal area that is characteristic of the condition

3. Lipase levels or amylase levels three times greater than the normal upper limit

Lab Tests

Blood tests are carried out to measure amylase and lipase levels in the blood. Amylase and lipase are digestive enzymes produced by the pancreas.

1. Lipase level test (preferred choice)

Lipase is an enzyme that digests fats. The test of lipase levels is more accurate than the test for amylase levels for diagnosing diseases of the pancreas, especially acute pancreatitis and acute alcoholic pancreatitis. Levels of the enzyme begin to rise between 4 and 8 hours following the onset of various pancreatitis symptoms. They will typically fall back to normal levels within seven days. If the lipase level is three times higher than the normal upper limit, acute pancreatitis is diagnosed. As chronic pancreatitis worsens, levels of lipase can be normal or below normal.

2. Amylase level test

Amylase is an enzyme that digests carbohydrates. Although the amylase test can signal pancreatic diseases, it is not as specific as the lipase test. This means elevated amylase levels can indicate an issue, but the cause might not be linked to the pancreas. Amylase levels begin to increase between 2 and 12 hours following the onset of various acute pancreatitis symptoms and generally return to normal levels within seven days. If levels are three times higher than the normal upper limit, acute pancreatitis is probable. Amylase levels can also be monitored in individuals with chronic pancreatitis. The levels will typically be somewhat elevated until cell damage to cells that manufacture the enzyme becomes extensive, at which stage amylase levels in the blood are likely to be decreased.

There are further blood tests than can be used to aid in the diagnosis of acute pancreatitis or help to detect complications. Such tests can include:

In addition to blood tests, other lab tests can be used to help diagnose and monitor chronic pancreatitis, including:

  • Fecal fat test to detect an excess of fat in a stool sample, which is often one of the first signs of pancreatic insufficiency. The stool elastase test (see below) is easier to carry out, so the fecal fat test is less commonly done.
  • Stool elastase test to measure the levels of elastase (a pancreatic enzyme) in a stool sample. Pancreatic insufficiency results in reduced levels of the enzyme in stools. Chronic pancreatitis can cause pancreatic insufficiency.
  • Immunoreactive trypsinogen (IRT) blood test to measure trypsinogen levels. Trypsinogen, made by the pancreas, is the inactive precursor of trypsin, an enzyme that digests protein. Elevated IRT levels can be a sign.
  • Chymotrypsin test to measure chymotrypsin in stools. Chymotrypsin is a pancreatic enzyme that digests proteins, and an absence of it in stools signifies pancreatic insufficiency.
  • Genetic mutation tests, such as cystic fibrosis gene mutation testing and test for other genes known to cause hereditary pancreatitis.
  • Chloride test (aka sweat test) to diagnose cystic fibrosis.