Laboratory-immunological diagnostics of complicated flow of necrotic pancreatitis

Abstract

Purpose of the study. Justify the additional laboratory and immunological possibilities of diagnosing the complications of necrotic pancreatitis. Materials and methods. A retrospective analysis of the case history of patients with edematous and necrotic pancreatitis has been carried out, and 1060 case histories have been analyzed. By special methods, 30 patients with acute pancreatitis were examined. Laboratory and immunological studies were carried out three times: 1 research – upon admission; 2 studies – on the 7th day; 3 studies – 14 days. Results. The conducted clinical researches and analysis of results allowed working out the method of diagnostics of local complications, based on quantitative estimation of level of lymphocytes. At level of lymphocytes up to 13% is very high probability of fluid collection development; from 13% to 25% high probability; from 25% to 37% – moderate probability; above 37% – low probability of intraand peripancreatic fluid collections. In general, a comparison of the dynamics of Ig subclasses showed that IgG1 and IgG3 tended to gradually increase. Conclusions. Among the laboratory parameters of the complicated course of necrotic pancreatitis, the most significant is the change in lymphocytes. The distribution of individual IgG subclasses suggests that severe necrotic forms overlap with a proven increase in the quantitative composition of IgG1 and IgG3, which is a confirmation of the pro inflammatory variant of the development of SIRS and requires correction of therapeutic tactics.

Keywords

• necrotizing pancreatitis
• complicated course
• diagnostics