Inflammatory markers of disease severity in acute pancreatitis

Acute pancreatitis is a sudden-onset inflammatory condition of the pancreas that is associated with severe complications in a subset of patients. Early determination of severity is important, because immediate and specific interventions can be instituted that will improve outcome, including prevention of some early deaths. The severity of acute pancreatitis is a function of the amount of pancreas that is injured and the intensity of the inflammatory response, Early death often is linked to systemic inflammatory response syndrome (SIRS) with cardiovascular collapse or acute respiratory distress syndrome, while late death more often is associated with infected pancreatic necrosis and multi-organ system failure, This article reviews laboratory-based markers that predict a severe clinical course and pancreatic necrosis early in the clinical course. New genetic markers that may predict a severe course, such is MCP-1, also are considered.