Springer Online Journal Archives 1860-2000
Abstract Post-endoscopic retrogradecholangiopancreatography (ERCP) pancreatitis has beensuggested as a model for acute pancreatitis (AP), whichallows evaluation of early alterations in the timecourse of the disease. The influence of the clinical courseon procalcitonin (PCT), serum amyloid A (SAA), andseveral proinflammatory and inhibitory cytokines wasevaluated in patients with AP following ERCP. Blood samples were prospectively collected frompatients undergoing ERCP. The incidence of ERCP-inducedpancreatic damage, defined as abdominal complaints, athreefold increase of serum lipase, and elevation of CRP from 〈10 to 〉20 mg/liter was 12.8%(12/94). Only mild clinical courses of acutepancreatitis were observed. PCT significantly increasedin subjects with post-ERCP pancreatitis after 24 hr. However, PCT levels did not exceed 0.5 ng/ml inany patient. Interleukin-1 receptor antagonist (IL-1RA)began to differ from baseline 2 hr after ERCP, followedby interleukin-6 (IL-6, 6 hr), solubilized tumor necrosis factor-α receptor II(sTNF-αRII, 24 hr) and SAA (24 hr). Interleukin 10(IL-10) showed marked interindividual variations with noobvious peak. Among all parameters evaluated, only peak values of IL-6 and IL-10 showedsignificant correlations with the reported pain score(r2 = 0.62/0.78), degree of ampullarirritation (r2 = NS/0.87), and the durationof ERCP (r2 = 0.58/0.76). No correlation was found with the volume of theinjected contrast agent. We conclude that IL-10 and IL-6appear to be useful to monitor patients after ERCP. Theabsence of any PCT elevation in the present study is in accordance with the clinical courseof the patients who suffered from mild pancreatic damagewithout systemic or infectious complications.
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