Browsing by Author "Korc, Paul"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Can We Detect Chronic Pancreatitis With Low Serum Pancreatic Enzyme Levels?
    (Lippincott, Williams, and Wilkins, 2016-09) Kwon, Chang-Il; Kim, Hong Joo; Korc, Paul; Choi, Eun Kwang; McNulty, Gail M.; Easler, Jeffrey J.; El Hajj, Ihab I.; Watkins, James; Fogel, Evan L.; McHenry, Lee; Zimmerman, Michelle K.; Sherman, Stuart; Lehman, Glen A.; Department of Medicine, IU School of Medicine
    Objectives: The aims of this study were to evaluate whether serum pancreatic enzyme levels could be used to aid screening for chronic pancreatitis (CP). Methods: 170 healthy volunteers were screened and prospectively enrolled in the control group. 150 patients who were diagnosed with calcific CP were enrolled in the patient group by retrospective review. Serum amylase and lipase levels were compared between the 2 groups. Results: The mean values ± SD of the control group were compared with those of the patient group for serum amylase level (48.1 ± 13.2 vs 34.8 ± 17.2 U/L, P < 0.001) and serum lipase level (26.4 ± 11.3 vs 16.3 ± 11.2 U/L, P < 0.001). On the receiver operating characteristic curve analysis for amylase level, area under the curve was 0.740 (95% confidence interval), and sensitivity and specificity were 38.7% and 94.1%, respectively, with a cutoff value of 27.5 U/L. On the receiver operating characteristic curve analysis for lipase level, area under the curve was 0.748 (95% confidence interval), and sensitivity and specificity were 33.3% and 95.9%, respectively, with a cutoff value of 10.5 U/L. Conclusions: Our results suggest that low serum pancreatic enzyme levels can be used to aid in detection of CP.
  • Thumbnail Image
    Item
    Serum amylase and lipase levels in healthy volunteers assessed by multiple commercial analyzers: Variability with established reference values
    (Journal of Gastroenterology Research and Practice, 2021) Kumar, Vinod; Gromski, Mark A.; Kwon, Chang-Il; Zimmerman, Michelle K.; McNulty, Gail M.; Korc, Paul; Choi, Eun Kwang; Easler, Jeffrey J.; Watkins, James; Fogel, Evan L.; Sherman, Stuart; Lehman, Glen A.; Medicine, School of Medicine
    Background/Aims: Although serum pancreatic enzyme measurements for amylase and lipase are the most widely used biochemical tests for the diagnosis of pancreatitis, limitations for their interpretation of pancreatic disease do exist. An international reference method or an evidence-based cut-off value of serum pancreatic enzyme levels has not been established to facilitate standardization. Therefore, different analytic methods for serum pancreatic enzyme levels have verified their own Reference Ranges (RR) as normal values. The aim of this study is to evaluate the frequency of serum pancreatic enzyme values outside of the RR in healthy volunteers, using 5 different pancreatic enzyme analyzers to determine variability of values between analyzers. Methods: Healthy volunteers were screened to exclude a history of pancreatic disease or pancreatic surgery, severe gastrointestinal disease, excess alcohol intake, tobacco use, amongst other conditions. Volunteers were prospectively enrolled and blood samples from a single draw were analyzed for serum pancreatic enzyme levels on five different automated chemistry analyzer platforms. Whether or not the results were within each analyzer's institutional RR was evaluated. Results: Among screened healthy volunteers, 180 participants were enrolled who met the inclusion criteria. Serum amylase results were outside the RR in 8 (4.4%), 11 (7.2%), 19 (10.5%), 6 (3.3%) and 7 (3.9%) subjects, respectively, based on the 5 separate analyzers. Serum lipase results were not within the RR in 3 (1.7%), 20 (13.2%), 13 (7.2%), 1 (0.6%) and 2 (1.1%) subjects, respectively. Among all 22 (12.2%) subjects that were outliers of the serum amylase level, 10 (5.6%) of those subjects were outside of the RR for two or more analyzers. In contrast, among all 32 (17.8%) subjects who were outliers of serum lipase level, only four subjects (2.2%) were outside of the RR for two or more analyzers. Conclusion: Although there was slight variability in test results for serum amylase and lipase between different commonly available testing systems in healthy subjects, no values exceeded three times the upper limit of normal. There was a small group of healthy volunteers that fell outside of the reference range on two or more analyzers. If there is clinical ambiguity due to an abnormal serum pancreatic enzyme, further diagnostic testing can be pursued. Standardization amongst pancreas enzyme analyzers with a unified reference methodology and standard would be beneficial.
  • Thumbnail Image
    Item
    An uncommon cause of chronic upper GI bleeding
    (Elsevier, 2016-09) Korc, Paul; McHenry, Lee; Department of Medicine, IU School of Medicine
    A 68-year-old woman presented with 4 years of iron deficiency anemia, requiring intravenous iron infusion. EGD revealed a 10-mm, cherry-red, sessile polypoid lesion on the major duodenal papilla. EUS examination was negative for deep invasion. Endoscopic ampullectomy was performed. A residual focus of lesion was treated with argon plasma coagulation (APC) after placement of a protective pancreatic duct stent (Video 1, available online at www.giejournal.org). Pathologic examination revealed a proliferation of capillaries with acute and chronic inflammation, consistent with pyogenic granuloma. Figure 1 demonstrates the lesion’s appearance (Fig. 1A) and the histology at ×100 magnification (Fig. 1B). Pyogenic granuloma is a lobular capillary hemangioma that presents as a polypoid red mass. Most often, they occur on the skin or oral mucosa but can, rarely, be found in the GI tract. Pyogenic granuloma of the duodenum is particularly rare. To our knowledge, only 2 cases of pyogenic granuloma (capillary hemangioma) with major papilla involvement have been reported, both in the Spanish language literature (de Caralt, 1986; Camacho, 2012). Pyogenic granuloma should be considered in the differential diagnosis of chronic GI bleeding. If the major papilla is involved, ampullectomy followed by APC for any residual lesion appears to be a safe and effective treatment.