THE DIAGNOSTIC VALUE OF SERUM C-REACTIVE PROTEIN, PROCALCITONIN, INTERLEUKIN-6 AND LACTATE DEHYDROGENASE IN PATIENTS WITH ACUTE PANCREATITIS

Abstract

Background: Acute pancreatitis is an inflammatory condition of the pancreas that varies in clinical severity, ranging from mild self-limiting episodes to life-threatening systemic involvement. Timely identification of severe disease is critical to guide appropriate management and improve patient outcomes. Several biomarkers have emerged as promising tools for early diagnosis and risk stratification. This study evaluates the diagnostic significance of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and lactate dehydrogenase (LDH) in patients with acute pancreatitis.

Objective: To determine the diagnostic value of serum CRP, procalcitonin, interleukin-6, and LDH in patients diagnosed with acute pancreatitis.

Methods: This cross-sectional observational study was conducted over six months (February to August 2023) at the Department of Medicine, PEMH Rawalpindi. A total of 200 patients diagnosed with acute pancreatitis, based on serum lipase levels elevated 2–3 times the normal, were included. Blood samples were drawn at admission, 48 hours, and 72 hours. CRP, PCT, and LDH levels were analyzed using Beckman Coulter, while IL-6 was measured via ELISA. Patients were stratified into mild (n=94), moderate (n=74), and severe (n=32) based on clinical severity.

Results: Among the 200 patients, 145 (72.5%) were male and 55 (27.5%) females. In the mild group, mean CRP reduced from 90 ± 5 mg/L to 65 ± 2 mg/L, and PCT from 0.08 ± 0.02 to 0.065 ± 0.01 ng/ml. In moderate cases, CRP increased from 120 ± 7 to 141 ± 3 mg/L, and PCT from 0.10 ± 0.02 to 0.14 ± 0.01 ng/ml. In severe AP, CRP rose from 200 ± 10 to 246 ± 4 mg/L and PCT from 0.20 ± 0.02 to 0.25 ± 0.03 ng/mL by 72 hours (all p=0.05).

Conclusion: CRP and procalcitonin showed strong diagnostic relevance in assessing the severity of acute pancreatitis and monitoring disease progression. Interleukin-6 also demonstrated potential as a supportive biomarker.