Background/aims: The pancreatitis-associated protein (PAP) is undetectable in normal pancreatic secretion and overexpressed in the acute phase of pancreatitis. We investigated whether serum PAP could be an indicator of the course of acute pancreatitis.
Methods: Serum PAP was retrospectively monitored in 98 patients with acute pancreatitis during their stay in the hospital. Patients were classified according to the severity of their disease as group I (< or = 1 complication), group II (> or = 2 complications), or group III (lethal pancreatitis).
Results: At admission, 34% of patients, all from group I, had normal PAP values (< 10 micrograms/L). None of them developed complications. They had a significantly shorter stay in the hospital than patients with elevated PAP (6.2 days vs. 14.9 days). In all patients, serum PAP increased after admission to a maximum, which correlated significantly to the severity of the disease. Average peak values were 22.2 micrograms/L and 240.0 micrograms/L in group I patients with normal or high PAP at admission, 963.0 micrograms/L and 1436.0 micrograms/L in groups II and III. Serum PAP decreased steadily during recovery.
Conclusions: Monitoring serum PAP in patients with acute pancreatitis would provide (1) at admission, selection of most patients who will not develop complications; (2) a dynamic assessment of severity; and (3) anticipation of the patient's recovery.