Serum trypsin levels have been estimated by radioimmunoassay in 26 healthy controls (248 +/- 94.9 micrograms/l; mean +/- s.d.), 12 patients with chronic renal failure (1100 +/- 584 micrograms/l), 34 with acute pancreatitis (1399 +/- 618 micrograms/l) and 23 with acute non-pancreatic abdominal conditions. Mean serum trypsin in acute pancreatitis and in chronic renal failure was significantly higher than in control group (P less than 0.001). Serum trypsin levels were well above the upper limit of normality in all patients with acute pancreatitis and in all but one with chronic renal failure. Serum trypsin was markedly raised in one patient with a traumatic haemoperitoneum and in one of the 11 with peptic ulcer perforation, and moderately raised in 3 of the 6 with acute cholecystitis. Determination of serum trypsin seems to be a specific test for acute pancreatitis, provided renal failure has been excluded. However, the authors suggest it should be prospectively measured in a larger series of acute non-pancreatic abdominal conditions.
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