Amylase
Lipase |
- Elevation > 3x the upper limit of normal is consistent with a diagnosis of acute pancreatitis
- Degree of enzyme elevation does not correlate with disease severity
- Amylase rises rapidly and may fall within the first 48 hrs of pancreatitis
- Lipase rises more slowly but may remain elevated for weeks after the initial pancreatic injury
- Enzymes may be elevated in children with chronic vomiting or gastritis
|
CMP
GGT |
- Electrolytes may be deranged depending on duration of symptoms and vomiting
- Initial BUN elevation correlates with disease severity
- Follow serially to assess severity and response to therapy
- Hypoalbuminemia may be followed serially to assess severity
- Hypercalcemia is a rare cause of acute pancreatitis
- Aminotransferase (AST/ALT) elevation, hyperbilirubinemia, and elevated alkaline phosphatase or GGT suggest an obstructive process such as cholelithiasis or autoimmune pancreatitis
|
Magnesium
Phosphorus |
Not routinely ordered except in the setting of sepsis or oncologic diagnosis |
| CBC with Differential |
- Leukocyte derangements may suggest an infectious etiology or trigger for acute pancreatitis
- Children with necrotizing pancreatitis may have life-threatening intra-abdominal bleeding, hemoglobin may suggest blood loss or serve as a baseline for serial measurements
- Eosinophilia may indicate a parasitic etiology
|
| Urinalysis |
Followed serially to assess fluid status and response to hyperhydration |
Blood Culture
Fungal Culture |
Not routinely ordered unless febrile or clinical suspicion for sepsis |
IgG Subtypes
Celiac Profile
Acylcarnitine Profile
Plasma Amino Acids
Urine Organic Acids
Stool Ova and Parasites |
Additional labs for acute recurrent pancreatitis |