Time course of changes in serum activity of the P3 isoform of pancreatic amylase isoenzyme in patients with acute pancreatitis.

We studied the temporal sequence of serum P3 isoamylase changes in patients with acute pancreatitis, in comparison with serum pancreatic lipase (LPS) activity. Twenty-four hospitalized patients with acute pancreatitis, the onset not more than 12 h previously, were admitted to the study. Serum samples were collected daily for 6 days after onset for enzyme determinations. Measurements in the 48-h period after the onset of acute pancreatitis showed clinical sensitivities of total amylase, P3 isoform and LPS of 100%. During the following period, LPS and P3 isoform activities decreased with time with parallel changes, still showing diagnostic sensitivity significantly higher than total amylase. P3 isoform and LPS appear to be interchangeable markers of pathological release of pancreatic enzymes into the bloodstream during acute pancreatitis. However, LPS determination is more convenient because of its simplicity and shorter turnaround time.