Lipase

CPT: 83690
Updated on 11/20/2017
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Test Details

Use

Diagnose pancreatitis, more specific for pancreatitis than is serum amylase; diagnose peritonitis, strangulated or infarcted bowel, pancreatic cyst

Methodology

Colorimetric

Contraindications

Urine specimens are inappropriate for lipase. Lipase activity is usually absent in urine, possibly from inactivation of the enzyme.

Reference Interval

See table.

Age

Range (U/L)

Male

0 to 6 m

8−37

7 m to 1 y

11−34

2 to 17 y

11−38

≥18 y

13−78

Female

0 to 6 m

9−50

7 m to 1 y

10−37

2 to 17 y

12−45

18 to 70 y

14−72

≥71 y

14−85

Additional Information

Serum lipase is usually normal in patients with elevated serum amylase, without pancreatitis, who have peptic ulcer, salivary adenitis, inflammatory bowel disease, intestinal obstruction, and macroamylasemia. Coexistence of increased serum amylase with normal lipase may be a helpful clue to the presence of macroamylasemia.1 Lipase is elevated with amylase in acute pancreatitis, but the elevation of lipase is more prolonged.

In work-up of pancreatitis, in addition to serum lipase and amylase, the 2-hour urine amylase is of value. Electrolytes, serum calcium, glucose, and acetone are also often needed. Immunoreactive trypsin is technically more difficult than lipase and probably no better.2 The serum lipase:amylase ratio may help distinguish alcoholic from nonalcoholic pancreatitis. Ratios >2 (expressed as multiples of the upper limits of normal) suggest an alcoholic etiology.3 Lipase isoform or isoenzymes have been studied.4

Specimen Requirements

Specimen

Serum (preferred) or plasma

Volume

1 mL

Minimum Volume

0.5 mL

Container

Red-top tube, gel-barrier tube, or green-top (heparin) tube

Collection

Separate serum or plasma from cells within 45 minutes of collection.

Storage Instructions

Maintain specimen at room temperature.

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Improper labeling

Clinical Information

Footnotes

1. Andrews PA, Thomas PA. Macro-amylasaemia as a cause of persistently raised serum amylase. Br J Surg. 1988 Oct;75(10):1035.2464398
2. Lott JA, Speicher CE, Nemesánszky E. Is serum amylase an obsolete test in the diagnosis of acute pancreatitis? Arch Pathol Lab Med. 1985 Apr;109(4):314-315.2580500
3. Gumaste VV, Dave PB, Weissman D, Messer J. Lipase:amylase ratio. A new index that distinguishes acute episodes of alcoholic from nonalcoholic acute pancreatitis. Gastroenterology. 1991 Nov;101(5):1361-1366.1718808
4. Lott JA, Lu CJ. Lipase isoforms and amylase isoenzymes: Assays and application in the diagnosis of acute pancreatitis. Clin Chem. 1991 Mar;37(3):361-368.1706232
1. Andrews PA, Thomas PA. Macro-amylasaemia as a cause of persistently raised serum amylase. Br J Surg. 1988 Oct; 75(10):1035. 2464398
2. Lott JA, Speicher CE, Nemesánszky E. Is serum amylase an obsolete test in the diagnosis of acute pancreatitis? Arch Pathol Lab Med. 1985 Apr; 109(4):314-315. 2580500
3. Gumaste VV, Dave PB, Weissman D, Messer J. Lipase:amylase ratio. A new index that distinguishes acute episodes of alcoholic from nonalcoholic acute pancreatitis. Gastroenterology. 1991 Nov; 101(5):1361-1366. 1718808
4. Lott JA, Lu CJ. Lipase isoforms and amylase isoenzymes: Assays and application in the diagnosis of acute pancreatitis. Clin Chem, 1991 Mar; 37(3):361-368. 1706232
1. Andrews PA, Thomas PA. Macro-amylasaemia as a cause of persistently raised serum amylase. Br J Surg. 1988 Oct;75(10):1035.2464398
2. Lott JA, Speicher CE, Nemesánszky E. Is serum amylase an obsolete test in the diagnosis of acute pancreatitis? Arch Pathol Lab Med. 1985 Apr;109(4):314-315.2580500
3. Gumaste VV, Dave PB, Weissman D, Messer J. Lipase:amylase ratio. A new index that distinguishes acute episodes of alcoholic from nonalcoholic acute pancreatitis. Gastroenterology. 1991 Nov;101(5):1361-1366.1718808
4. Lott JA, Lu CJ. Lipase isoforms and amylase isoenzymes: Assays and application in the diagnosis of acute pancreatitis. Clin Chem. 1991 Mar;37(3):361-368.1706232

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
001404 Lipase, Serum 3040-3 001404 Lipase, Serum U/L 3040-3

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