Biochemical indices of patients with enteric fever and pancreatitis: A comparative cross-sectional study

• Published in: Practical laboratory medicine Vol. 42; p. e00429
• Main Authors: Aidoo, Nathaniel Ebo, Ofori, Emmanuel Kwaku, Boima, Vincent, Nyarko, Eric Nana Yaw, Osei, John Cletus, Darkwah, Clement G., Gayflor, Morris O., Amponsah, Seth K., Asare-Anane, Henry
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-11-2024; Elsevier
• Subjects: Acute pancreatitis; Amylase; Elastase-1; Enteric fever; Lipase; Registered Report Stage II; Enteric fever; Acute pancreatitis; Elastase-1; Amylase; Lipase
• ISSN: 2352-5517; 2352-5517
• DOI: 10.1016/j.plabm.2024.e00429

Enteric fever (EF), a potentially fatal febrile illness, is prevalent in developing countries. Elevated levels of lipase and amylase in serum, typically associated with acute pancreatitis (AP), have been observed in patients with EF. The elevated enzymes in both conditions may lead to diagnostic confusion and care delays. This study aimed to determine biochemical indices that are peculiar to EF and AP.
A cross-sectional comparative study was conducted at the Korle-Bu Teaching Hospital, Ghana. Volunteers were categorized into three groups: EF (n = 32), AP (n = 30) and healthy controls (n = 31). A standard questionnaire was used to collect socio-demographic and clinical information from the participants. Blood and stool samples were obtained, followed by biochemical analysis: total amylase, lipase, pancreatic amylase, serum elastase 1, hepatic enzymes, calcium, magnesium, phosphate, stool colour, stool pH, and stool fat presence.
The AP group displayed higher total amylase, lipase, elastase-1, alkaline phosphatase, aspartate aminotransferase, and gamma-glutamyl transferase levels compared to the EF and control groups (p < 0.05 respectively). Elastase 1 levels were found to be high in all AP participants, whereas no elevations were observed in the EF group. Positive associations were observed in the AP and EF groups for lipase vs total amylase (ρ = .543, p = 0.001; ρ = .543, p = 0.001 for both).
Elevated levels of total/pancreatic amylase and lipase were found to be indicative of a patient with AP and EF. Further, elastase-1 was found to be a good biomarker to distinguish between AP and EF.
•Raised lipase and amylase typically associated with Acute Pancreatitis (AP) have been noted in Enteric Fever (EF) patients.•This shared biochemical pattern in both conditions may potentially cause diagnostic confusion and care delays.•Elastase 1 levels in serum discriminated between AP and EF when etiologies were unclear.