Serum alpha 2-macroglobulin-trypsin complex and early recognition of severe acute pancreatitis after endoscopic retrograde pancreatography.

Serum alpha 2-macroglobulin-trypsin complex (alpha 2M-T) was measured to differentiate the elevation of serum pancreatic enzymes caused by severe acute pancreatitis from simple elevation after endoscopic retrograde pancreatography (ERP). A patient with severe acute pancreatitis demonstrated marked elevation of serum alpha 2M-T. In patients without severe acute pancreatitis, serum alpha 2M-T did not rise in spite of elevated serum pancreatic enzymes. In conclusion, abdominal pain with elevated serum alpha 2M-T can be an early diagnostic clue to severe acute pancreatitis after ERP.