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Erectile Dysfunction
Erectile Dysfunction
Drugs
Lipase
Definition
Glycoprotein enzyme filtered by glomeruli and completely reabsorbed by proximal tubules; method should always include colipase in reagent
Normal range: 0 " “50 U/L
Use
Investigating pancreatic disorders, usually pancreatitis
More specific for pancreatitis than is for serum amylase; diagnosis of peritonitis, strangulated or infarcted bowel, pancreatic cyst
Interpretation
Increased In
Acute pancreatitis
Perforated or penetrating peptic ulcer, especially with involvement of the pancreas
Obstruction of pancreatic duct by
Stone
Drug-induced spasm of sphincter of Oddi (e.g., codeine, morphine, meperidine, methacholine, cholinergics) to levels 2 " “15 times normal
Partial obstruction plus drug stimulation
Chronic pancreatitis
Acute cholecystitis
Small bowel obstruction
Intestinal infarction
Acute and chronic renal failure (increased two to three times in 80% of patients and five times in 5% of patients)
Organ transplant (kidney, liver, heart), especially with complications (e.g., organ rejection, CMV infection, cyclosporin toxicity)
Alcoholism
DKA
After ERCP
Some cases of intracranial bleeding (unknown mechanism)
Macro forms in lymphoma, cirrhosis
Drugs
Induced acute pancreatitis (see preceding section on serum amylase)
Cholestatic effect (e.g., indomethacin)
Methodologic interference (e.g., pancreozymin [contains lipase], deoxycholate, glycocholate, taurocholate [prevent inactivation of enzyme], bilirubin [turbidimetric methods])
Chronic liver disease (e.g., cirrhosis) (usually ≤2 times normal)
Decreased In
Methodologic interference (e.g., presence of Hb, quinine, heavy metals, calcium ions)
Normal In
Mumps
Macroamylasemia
Lower value in neonates
Limitations
Certain drugs such as cholinergics and opiates may elevate serum lipase.
Renal disease may elevate the serum lipase.
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