“In acute pancreatitis, plasma amylase becomes elevated two to 12 hours after an episode of acute abdominal pain. Levels peak in 12-72 hours, usually reaching two to six times the upper limit of normal, then return to normal by four days. Amylase is a small protein and is excreted in urine in significant quantities. Urinary amy-lase rises in parallel with plasma amylase, but reaches higher levels and remains elevated for seven to 14 days. Renal excretion of amylase is increased in pancreatitis, and the ratio of amylase to creatinine clearance is a more specific test for acute pancreatitis than is plasma amylase. Lipase in plasma becomes abnormal four to eight hours following an episode of acute pancreatitis, reaches a peak level two to 50 times normal in approximately one day, and remains elevated for seven to 10 days. Recently, serum and urine levels of trypsinogen-2 have been shown to be very sensitive and specific indicators of pancreatits, but assays are not yet widely available.
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