Lab Test: Lipase (Blood) Level

Elevated levels of serum lipase may aid in the diagnosis of pancreatitis in HUS. Pancreatitis is not considered to be present unless elevations are greater than 4 tines the normal value or other evidence of pancreatitis is present.

Patients in ICU with elevated serum lipase levels above the upper limit of normal may have longer lengths of stay in the ICU, increased duration of mechanical ventilation, and significantly higher multiple-organ dysfunction scores.

Lipase specific is maximized by increasing the upper limit of the normal reference values. A diagnostic threshold 2 to 3 times normal provides the best achievable specificity without compromising sensitivity.

Lipase levels increase within 4 to 8 hours after the onset of acute pancreatitis, peak at 24 hours, and decrease within 8 to 14 days. Lipase elevation rarely persists beyond 14 days; prolonged increases typically signal poor prognosis or the presence of a pancreatic cyst.

Clinical Application

The most common cause of an elevated serum lipase level is acute pancreatitis.
Lipase is an enzyme secreted by the pancreas into the duodenum to break down triglycerides into fatty acids.
As with amylase lipase appears in the bloodstream following damage to or disease affecting the pancreatic acinar cells. Other conditions can be associated with elevated lipase levels. Lipase is excreted through the kidneys.
Therefore, elevated lipase levels are often found in patients with renal failure. Intestinal infarction or obstruction also can be associated with lipase elevation. However, the lipase elevations in non-pancreatic diseases are less than three tines the upper limit of normal as compared with pancreatitis, in which they are often 5 to 10 times normal values. In acute pancreatitis, elevated lipase levels usually parallel serum amylase levels.
Assays are highly dependent on substrate used. Assays that contain colipase and bile salts are more specific for pancreatic lipase.
Serum lipase levels are more useful in the late diagnosis of acute pancreatitis since they peak later and remain elevated longer than the serum amylase levels.
Increased levels may indicate:

Pancreatic diseases (e.g., acute pancreatitis, chronic relapsing pancreatitis, pancreatic cancer, pancreatic pseudocyst), biliary diseases (e.g., acute cholecystitis, cholangitis, extrahepatic duct obstruction), renal failure, intestinal diseases (e.g., bowel obstruction, infarction), salivary gland inflammation or tumor, or peptic ulcer disease

Related Tests

Amylase - disease affecting the pancreas also will cause elevations of this enzyme.

Drug-Lab Interactions

Drugs that may cause increased lipase levels include: bethanechol, codeine, indomethacin, meperidine, methacholine, and morphine.

Test Tube Needed

Procedure

Apply pressure or a pressure dressing to the venipuncture site and assess the site for bleeding.

Storage and Handling

What To Tell Patient Before & After

Instruct the patient to remain on nothing by mouth (NPO) status, except for water, for 8 to 12 hours before the test.

References

Smotkin J et al. Laboratory diagnostic tests in acute pancreatitis. Clin Gastroenterol 2002;34(4):459-62.
Vaziri ND et al. Pancreatic enzymes in patients with end-stage renal disease maintained on hemodialysis. Am J Gastroenterol 1988;83(4):410-2.
Yadav D et al. A critical evaluation of laboratory tests in acute pancreatitis. Am J Gastroenterol 2002 97(6):1309-18.
LaGow B et al., eds. PDR Lab Advisor. A Comprehensive Point-of-Care Guide for Over 600 Lab Tests. First ed. Montvale, NJ: Thomson PDR; 2007.

Pagana K, Pagana TJ eds. Mosby's Manual of Diagnostic and Laboratory Tests. 5^th Ed. St. Louis, Missouri. 2014

Keywords
Lipase, Lipase Lab Test, Lipase Test Pancreatitis, Pancreatitis Labs

Keywords