Which elevated serum level supports a diagnosis of acute pancreatitis?

The elevated serum level that most strongly supports a diagnosis of acute pancreatitis is serum lipase. In the context of acute pancreatitis, lipase is the more specific enzyme compared to amylase.

Lipase is an enzyme produced by the pancreas that breaks down fats. During an episode of acute pancreatitis, pancreatic cells become inflamed and release larger amounts of lipase into the bloodstream. Elevated levels of serum lipase can remain elevated longer than amylase after the onset of pancreatitis, making it a more reliable marker for diagnosing this condition.

While serum amylase can also be elevated in acute pancreatitis, it is less specific and can rise in various other conditions, such as gastrointestinal perforations or salivary gland issues. Therefore, while both enzymes might be tested, serum lipase is preferred for diagnosing acute pancreatitis due to its greater specificity and sensitivity in indicating pancreatic inflammation.

Serum bilirubin levels may be elevated in cases where there is biliary obstruction or a concurrent bile duct disease, which can arise due to gallstones but is not diagnostic for pancreatitis itself. Serum glucose may be affected by various metabolic disturbances in acute pancreatitis but is not a primary diagnostic marker for the condition.