Elastase in blood serum: Difference between revisions

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== Overview ==   
== Overview ==   
* The presence of elastase in the blood serum is caused by serine proteinase hydrolyzing elastic occuring in the endothelial cells, macrophages, and granulocytes
* The presence of elastase in the blood serum is caused by serine proteinase hydrolyzing elastic occuring in the endothelial cells, macrophages, and granulocytes.
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| '''In Pleural Effusion''' || '''480-2900 ng/ml'''
| '''In Pleural Effusion''' || '''480-2900 ng/ml'''
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==Causes of decreased elastase in blood serum==
==Causes of decreased elastase in blood serum==
* Hyperglycemia<ref name="Stegenga-2008">{{Cite journal  | last1 = Stegenga | first1 = ME. | last2 = van der Crabben | first2 = SN. | last3 = Blümer | first3 = RM. | last4 = Levi | first4 = M. | last5 = Meijers | first5 = JC. | last6 = Serlie | first6 = MJ. | last7 = Tanck | first7 = MW. | last8 = Sauerwein | first8 = HP. | last9 = van der Poll | first9 = T. | title = Hyperglycemia enhances coagulation and reduces neutrophil degranulation, whereas hyperinsulinemia inhibits fibrinolysis during human endotoxemia. | journal = Blood | volume = 112 | issue = 1 | pages = 82-9 | month = Jul | year = 2008 | doi = 10.1182/blood-2007-11-121723 | PMID = 18316629 }}</ref>
* Hyperglycemia<ref name="Stegenga-2008">{{Cite journal  | last1 = Stegenga | first1 = ME. | last2 = van der Crabben | first2 = SN. | last3 = Blümer | first3 = RM. | last4 = Levi | first4 = M. | last5 = Meijers | first5 = JC. | last6 = Serlie | first6 = MJ. | last7 = Tanck | first7 = MW. | last8 = Sauerwein | first8 = HP. | last9 = van der Poll | first9 = T. | title = Hyperglycemia enhances coagulation and reduces neutrophil degranulation, whereas hyperinsulinemia inhibits fibrinolysis during human endotoxemia. | journal = Blood | volume = 112 | issue = 1 | pages = 82-9 | month = Jul | year = 2008 | doi = 10.1182/blood-2007-11-121723 | PMID = 18316629 }}</ref>
* Prednisolone<ref name="de Kruif-2007">{{Cite journal  | last1 = de Kruif | first1 = MD. | last2 = Lemaire | first2 = LC. | last3 = Giebelen | first3 = IA. | last4 = van Zoelen | first4 = MA. | last5 = Pater | first5 = JM. | last6 = van den Pangaart | first6 = PS. | last7 = Groot | first7 = AP. | last8 = de Vos | first8 = AF. | last9 = Elliott | first9 = PJ. | title = Prednisolone dose-dependently influences inflammation and coagulation during human endotoxemia. | journal = J Immunol | volume = 178 | issue = 3 | pages = 1845-51 | month = Feb | year = 2007 | doi =  | PMID = 17237435 }}</ref>
* Prednisolone<ref name="de Kruif-2007">{{Cite journal  | last1 = de Kruif | first1 = MD. | last2 = Lemaire | first2 = LC. | last3 = Giebelen | first3 = IA. | last4 = van Zoelen | first4 = MA. | last5 = Pater | first5 = JM. | last6 = van den Pangaart | first6 = PS. | last7 = Groot | first7 = AP. | last8 = de Vos | first8 = AF. | last9 = Elliott | first9 = PJ. | title = Prednisolone dose-dependently influences inflammation and coagulation during human endotoxemia. | journal = J Immunol | volume = 178 | issue = 3 | pages = 1845-51 | month = Feb | year = 2007 | doi =  | PMID = 17237435 }}</ref>


==Causes of increased elastase in blood serum<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>==  
==Causes of increased elastase in blood serum<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>==  
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===Common Causes===
===Common Causes===
* [[Acute lung injury]]<ref name="Donnelly-1995">{{Cite journal  | last1 = Donnelly | first1 = SC. | last2 = MacGregor | first2 = I. | last3 = Zamani | first3 = A. | last4 = Gordon | first4 = MW. | last5 = Robertson | first5 = CE. | last6 = Steedman | first6 = DJ. | last7 = Little | first7 = K. | last8 = Haslett | first8 = C. | title = Plasma elastase levels and the development of the adult respiratory distress syndrome. | journal = Am J Respir Crit Care Med | volume = 151 | issue = 5 | pages = 1428-33 | month = May | year = 1995 | doi = 10.1164/ajrccm.151.5.7735596 | PMID = 7735596 }}</ref>
* [[Acute lung injury]]<ref name="Donnelly-1995">{{Cite journal  | last1 = Donnelly | first1 = SC. | last2 = MacGregor | first2 = I. | last3 = Zamani | first3 = A. | last4 = Gordon | first4 = MW. | last5 = Robertson | first5 = CE. | last6 = Steedman | first6 = DJ. | last7 = Little | first7 = K. | last8 = Haslett | first8 = C. | title = Plasma elastase levels and the development of the adult respiratory distress syndrome. | journal = Am J Respir Crit Care Med | volume = 151 | issue = 5 | pages = 1428-33 | month = May | year = 1995 | doi = 10.1164/ajrccm.151.5.7735596 | PMID = 7735596 }}</ref>
* [[Ischemia-Reperfusion Injury]]<ref name="Hughes-2006">{{Cite journal  | last1 = Hughes | first1 = SF. | last2 = Cotter | first2 = MJ. | last3 = Evans | first3 = SA. | last4 = Jones | first4 = KP. | last5 = Adams | first5 = RA. | title = Role of leucocytes in damage to the vascular endothelium during ischaemia-reperfusion injury. | journal = Br J Biomed Sci | volume = 63 | issue = 4 | pages = 166-70 | month =  | year = 2006 | doi =  | PMID = 17201205 }}</ref>
* [[Ischemia]]-[[reperfusion Injury]]<ref name="Hughes-2006">{{Cite journal  | last1 = Hughes | first1 = SF. | last2 = Cotter | first2 = MJ. | last3 = Evans | first3 = SA. | last4 = Jones | first4 = KP. | last5 = Adams | first5 = RA. | title = Role of leucocytes in damage to the vascular endothelium during ischaemia-reperfusion injury. | journal = Br J Biomed Sci | volume = 63 | issue = 4 | pages = 166-70 | month =  | year = 2006 | doi =  | PMID = 17201205 }}</ref>
* Neutrophilic asthma<ref name="Baines-2011">{{Cite journal  | last1 = Baines | first1 = KJ. | last2 = Simpson | first2 = JL. | last3 = Wood | first3 = LG. | last4 = Scott | first4 = RJ. | last5 = Gibson | first5 = PG. | title = Systemic upregulation of neutrophil α-defensins and serine proteases in neutrophilic asthma. | journal = Thorax | volume = 66 | issue = 11 | pages = 942-7 | month = Nov | year = 2011 | doi = 10.1136/thx.2010.157719 | PMID = 21785157 }}</ref>
* Neutrophilic [[asthma]]<ref name="Baines-2011">{{Cite journal  | last1 = Baines | first1 = KJ. | last2 = Simpson | first2 = JL. | last3 = Wood | first3 = LG. | last4 = Scott | first4 = RJ. | last5 = Gibson | first5 = PG. | title = Systemic upregulation of neutrophil α-defensins and serine proteases in neutrophilic asthma. | journal = Thorax | volume = 66 | issue = 11 | pages = 942-7 | month = Nov | year = 2011 | doi = 10.1136/thx.2010.157719 | PMID = 21785157 }}</ref>
* Exercise<ref name="Hu-2004">{{Cite journal  | last1 = Hu | first1 = H. | last2 = Johansson | first2 = BL. | last3 = Hjemdahl | first3 = P. | last4 = Li | first4 = N. | title = Exercise-induced platelet and leucocyte activation is not enhanced in well-controlled Type 1 diabetes, despite increased activity at rest. | journal = Diabetologia | volume = 47 | issue = 5 | pages = 853-9 | month = May | year = 2004 | doi = 10.1007/s00125-004-1378-7 | PMID = 15095037 }}</ref><ref name="Li-2007">{{Cite journal  | last1 = Li | first1 = N. | last2 = He | first2 = S. | last3 = Blombäck | first3 = M. | last4 = Hjemdahl | first4 = P. | title = Platelet activity, coagulation, and fibrinolysis during exercise in healthy males: effects of thrombin inhibition by argatroban and enoxaparin. | journal = Arterioscler Thromb Vasc Biol | volume = 27 | issue = 2 | pages = 407-13 | month = Feb | year = 2007 | doi = 10.1161/01.ATV.0000253906.19648.ac | PMID = 17138937 }}</ref>
* [[Celiac disease]]<ref name="Carroccio-2006">{{Cite journal  | last1 = Carroccio | first1 = A. | last2 = Di Prima | first2 = L. | last3 = Scalici | first3 = C. | last4 = Soresi | first4 = M. | last5 = Cefalù | first5 = AB. | last6 = Noto | first6 = D. | last7 = Averna | first7 = MR. | last8 = Montalto | first8 = G. | last9 = Iacono | first9 = G. | title = Unexplained elevated serum pancreatic enzymes: a reason to suspect celiac disease. | journal = Clin Gastroenterol Hepatol | volume = 4 | issue = 4 | pages = 455-9 | month = Apr | year = 2006 | doi = 10.1016/j.cgh.2005.12.027 | PMID = 16616350 }}</ref>
* Systolic [[hypertension]]<ref name="Yasmin-2005">{{Cite journal  | last1 = Yasmin | first1 = CM. | last2 = McEniery | first2 = S. | last3 = Wallace | first3 = Z. | last4 = Dakham | first4 = P. | last5 = Pulsalkar | first5 = P. | last6 = Pusalkar | first6 = K. | last7 = Maki-Petaja | first7 = MJ. | last8 = Ashby | first8 = JR. | last9 = Cockcroft | first9 = IB. | title = Matrix metalloproteinase-9 (MMP-9), MMP-2, and serum elastase activity are associated with systolic hypertension and arterial stiffness. | journal = Arterioscler Thromb Vasc Biol | volume = 25 | issue = 2 | pages = 372 | month = Feb | year = 2005 | doi = 10.1161/01.ATV.0000151373.33830.41 | PMID = 15556929 }}</ref>
* [[Endotoxemia]]<ref name="O'Brien-2004">{{Cite journal  | last1 = O'Brien | first1 = JM. | last2 = Abraham | first2 = E. | title = Human models of endotoxemia and recombinant human activated protein C. | journal = Crit Care Med | volume = 32 | issue = 5 Suppl | pages = S202-8 | month = May | year = 2004 | doi =  | PMID = 15118518 }}</ref><ref name="Pajkrt-1997">{{Cite journal  | last1 = Pajkrt | first1 = D. | last2 = Camoglio | first2 = L. | last3 = Tiel-van Buul | first3 = MC. | last4 = de Bruin | first4 = K. | last5 = Cutler | first5 = DL. | last6 = Affrime | first6 = MB. | last7 = Rikken | first7 = G. | last8 = van der Poll | first8 = T. | last9 = ten Cate | first9 = JW. | title = Attenuation of proinflammatory response by recombinant human IL-10 in human endotoxemia: effect of timing of recombinant human IL-10 administration. | journal = J Immunol | volume = 158 | issue = 8 | pages = 3971-7 | month = Apr | year = 1997 | doi =  | PMID = 9103468 }}</ref>
* [[Diabetes mellitus]]<ref name="Hu-2004">{{Cite journal  | last1 = Hu | first1 = H. | last2 = Li | first2 = N. | last3 = Yngen | first3 = M. | last4 = Ostenson | first4 = CG. | last5 = Wallén | first5 = NH. | last6 = Hjemdahl | first6 = P. | title = Enhanced leukocyte-platelet cross-talk in Type 1 diabetes mellitus: relationship to microangiopathy. | journal = J Thromb Haemost | volume = 2 | issue = 1 | pages = 58-64 | month = Jan | year = 2004 | doi =  | PMID = 14717967 }}</ref>
* Carotid atherosclerotic [[plaque]] development<ref name="Zureik-2002">{{Cite journal  | last1 = Zureik | first1 = M. | last2 = Robert | first2 = L. | last3 = Courbon | first3 = D. | last4 = Touboul | first4 = PJ. | last5 = Bizbiz | first5 = L. | last6 = Ducimetière | first6 = P. | title = Serum elastase activity, serum elastase inhibitors, and occurrence of carotid atherosclerotic plaques: the Etude sur le Vieillissement Artériel (EVA) study. | journal = Circulation | volume = 105 | issue = 22 | pages = 2638-45 | month = Jun | year = 2002 | doi =  | PMID = 12045170 }}</ref>
* [[Oxidative stress]]<ref name="Clermont-2001">{{Cite journal  | last1 = Clermont | first1 = G. | last2 = Lecour | first2 = S. | last3 = Cabanne | first3 = JF. | last4 = Motte | first4 = G. | last5 = Guilland | first5 = JC. | last6 = Chevet | first6 = D. | last7 = Rochette | first7 = L. | title = Vitamin E-coated dialyzer reduces oxidative stress in hemodialysis patients. | journal = Free Radic Biol Med | volume = 31 | issue = 2 | pages = 233-41 | month = Jul | year = 2001 | doi =  | PMID = 11440835 }}</ref>
* [[Essential thrombocythemia]]<ref name="Falanga-2000">{{Cite journal  | last1 = Falanga | first1 = A. | last2 = Marchetti | first2 = M. | last3 = Evangelista | first3 = V. | last4 = Vignoli | first4 = A. | last5 = Licini | first5 = M. | last6 = Balicco | first6 = M. | last7 = Manarini | first7 = S. | last8 = Finazzi | first8 = G. | last9 = Cerletti | first9 = C. | title = Polymorphonuclear leukocyte activation and hemostasis in patients with essential thrombocythemia and polycythemia vera. | journal = Blood | volume = 96 | issue = 13 | pages = 4261-6 | month = Dec | year = 2000 | doi =  | PMID = 11110700 }}</ref>
* [[Polycythemia vera]]<ref name="Falanga-2000">{{Cite journal  | last1 = Falanga | first1 = A. | last2 = Marchetti | first2 = M. | last3 = Evangelista | first3 = V. | last4 = Vignoli | first4 = A. | last5 = Licini | first5 = M. | last6 = Balicco | first6 = M. | last7 = Manarini | first7 = S. | last8 = Finazzi | first8 = G. | last9 = Cerletti | first9 = C. | title = Polymorphonuclear leukocyte activation and hemostasis in patients with essential thrombocythemia and polycythemia vera. | journal = Blood | volume = 96 | issue = 13 | pages = 4261-6 | month = Dec | year = 2000 | doi =  | PMID = 11110700 }}</ref>
* [[Extracorporeal detoxification]]<ref name="Kramer-2000">{{Cite journal  | last1 = Kramer | first1 = L. | last2 = Gendo | first2 = A. | last3 = Madl | first3 = C. | last4 = Ferrara | first4 = I. | last5 = Funk | first5 = G. | last6 = Schenk | first6 = P. | last7 = Sunder-Plassmann | first7 = G. | last8 = Hörl | first8 = WH. | title = Biocompatibility of a cuprophane charcoal-based detoxification device in cirrhotic patients with hepatic encephalopathy. | journal = Am J Kidney Dis | volume = 36 | issue = 6 | pages = 1193-200 | month = Dec | year = 2000 | doi = 10.1053/ajkd.2000.19834 | PMID = 11096044 }}</ref>
* [[Esophagogastrectomy]]<ref name="Reid-2000">{{Cite journal  | last1 = Reid | first1 = PT. | last2 = Donnelly | first2 = SC. | last3 = MacGregor | first3 = IR. | last4 = Grant | first4 = IS. | last5 = Cameron | first5 = E. | last6 = Walker | first6 = W. | last7 = Merrick | first7 = MV. | last8 = Haslett | first8 = C. | title = Pulmonary endothelial permeability and circulating neutrophil-endothelial markers in patients undergoing esophagogastrectomy. | journal = Crit Care Med | volume = 28 | issue = 9 | pages = 3161-5 | month = Sep | year = 2000 | doi =  | PMID = 11008975 }}</ref>
* [[Alpha1-antitrypsin deficiency]]<ref name="Hill-2000">{{Cite journal  | last1 = Hill | first1 = AT. | last2 = Bayley | first2 = DL. | last3 = Campbell | first3 = EJ. | last4 = Hill | first4 = SL. | last5 = Stockley | first5 = RA. | title = Airways inflammation in chronic bronchitis: the effects of smoking and alpha1-antitrypsin deficiency. | journal = Eur Respir J | volume = 15 | issue = 5 | pages = 886-90 | month = May | year = 2000 | doi =  | PMID = 10853853 }}</ref>
* [[Migraine]]<ref name="Tzourio-2000">{{Cite journal  | last1 = Tzourio | first1 = C. | last2 = El Amrani | first2 = M. | last3 = Robert | first3 = L. | last4 = Alpérovitch | first4 = A. | title = Serum elastase activity is elevated in migraine. | journal = Ann Neurol | volume = 47 | issue = 5 | pages = 648-51 | month = May | year = 2000 | doi =  | PMID = 10805337 }}</ref>
* [[Granulocyte colony-stimulating factor]]<ref name="Falanga-1999">{{Cite journal  | last1 = Falanga | first1 = A. | last2 = Marchetti | first2 = M. | last3 = Evangelista | first3 = V. | last4 = Manarini | first4 = S. | last5 = Oldani | first5 = E. | last6 = Giovanelli | first6 = S. | last7 = Galbusera | first7 = M. | last8 = Cerletti | first8 = C. | last9 = Barbui | first9 = T. | title = Neutrophil activation and hemostatic changes in healthy donors receiving granulocyte colony-stimulating factor. | journal = Blood | volume = 93 | issue = 8 | pages = 2506-14 | month = Apr | year = 1999 | doi =  | PMID = 10194429 }}</ref>
* [[Antineutrophil cytoplasmic antibody-associated vasculitis]]<ref name="Haubitz-1997">{{Cite journal  | last1 = Haubitz | first1 = M. | last2 = Schulzeck | first2 = P. | last3 = Schellong | first3 = S. | last4 = Schulze | first4 = M. | last5 = Koch | first5 = KM. | last6 = Brunkhorst | first6 = R. | title = Complexed plasma elastase as an in vivo marker for leukocyte activation in antineutrophil cytoplasmic antibody-associated vasculitis. | journal = Arthritis Rheum | volume = 40 | issue = 9 | pages = 1680-4 | month = Sep | year = 1997 | doi = 10.1002/1529-0131(199709)40:9lt;1680::AID-ART18gt;3.0.CO;2-Q | PMID = 9324023 }}</ref>
* [[Cystic fibrosis]]<ref name="Costello-1996">{{Cite journal  | last1 = Costello | first1 = CM. | last2 = O'Connor | first2 = CM. | last3 = Finlay | first3 = GA. | last4 = Shiels | first4 = P. | last5 = FitzGerald | first5 = MX. | last6 = Hayes | first6 = JP. | title = Effect of nebulised recombinant DNase on neutrophil elastase load in cystic fibrosis. | journal = Thorax | volume = 51 | issue = 6 | pages = 619-23 | month = Jun | year = 1996 | doi =  | PMID = 8693445 }}</ref>
* [[Cardiopulmonary bypass]]<ref name="Hind-1988">{{Cite journal  | last1 = Hind | first1 = CR. | last2 = Griffin | first2 = JF. | last3 = Pack | first3 = S. | last4 = Latchman | first4 = YE. | last5 = Drake | first5 = HF. | last6 = Jones | first6 = HM. | last7 = Brostoff | first7 = J. | last8 = Dormandy | first8 = TL. | last9 = Treasures | first9 = T. | title = Effect of cardiopulmonary bypass on circulating concentrations of leucocyte elastase and free radical activity. | journal = Cardiovasc Res | volume = 22 | issue = 1 | pages = 37-41 | month = Jan | year = 1988 | doi =  | PMID = 3048690 }}</ref><ref>{{Cite journal  | last1 = Tönz | first1 = M. | last2 = Mihaljevic | first2 = T. | last3 = von Segesser | first3 = LK. | last4 = Fehr | first4 = J. | last5 = Schmid | first5 = ER. | last6 = Turina | first6 = MI. | title = Acute lung injury during cardiopulmonary bypass. Are the neutrophils responsible? | journal = Chest | volume = 108 | issue = 6 | pages = 1551-6 | month = Dec | year = 1995 | doi =  | PMID = 7497759 }}</ref>
* [[Adult respiratory distress syndrome]]<ref name="Rivkind-1989">{{Cite journal  | last1 = Rivkind | first1 = AI. | last2 = Siegel | first2 = JH. | last3 = Guadalupi | first3 = P. | last4 = Littleton | first4 = M. | title = Sequential patterns of eicosanoid, platelet, and neutrophil interactions in the evolution of the fulminant post-traumatic adult respiratory distress syndrome. | journal = Ann Surg | volume = 210 | issue = 3 | pages = 355-72; discussion 372-3 | month = Sep | year = 1989 | doi =  | PMID = 2549891 }}</ref><ref>{{Cite journal  | last1 = Donnelly | first1 = SC. | last2 = MacGregor | first2 = I. | last3 = Zamani | first3 = A. | last4 = Gordon | first4 = MW. | last5 = Robertson | first5 = CE. | last6 = Steedman | first6 = DJ. | last7 = Little | first7 = K. | last8 = Haslett | first8 = C. | title = Plasma elastase levels and the development of the adult respiratory distress syndrome. | journal = Am J Respir Crit Care Med | volume = 151 | issue = 5 | pages = 1428-33 | month = May | year = 1995 | doi = 10.1164/ajrccm.151.5.7735596 | PMID = 7735596 }}</ref><ref name="Rocker-1989">{{Cite journal  | last1 = Rocker | first1 = GM. | last2 = Wiseman | first2 = MS. | last3 = Pearson | first3 = D. | last4 = Shale | first4 = DJ. | title = Diagnostic criteria for adult respiratory distress syndrome: time for reappraisal. | journal = Lancet | volume = 1 | issue = 8630 | pages = 120-3 | month = Jan | year = 1989 | doi =  | PMID = 2563047 }}</ref>
* [[Hemodialysis]]<ref>{{Cite journal  | last1 = Cheung | first1 = AK. | last2 = Faezi-Jenkin | first2 = B. | last3 = Leypoldt | first3 = JK. | title = Effect of thrombosis on complement activation and neutrophil degranulation during in vitro hemodialysis. | journal = J Am Soc Nephrol | volume = 5 | issue = 1 | pages = 110-5 | month = Jul | year = 1994 | doi =  | PMID = 7948777 }}</ref>
* [[Pancreatic cancer]]<ref name="Tatsuta-1984">{{Cite journal  | last1 = Tatsuta | first1 = M. | last2 = Yamamura | first2 = H. | last3 = Noguchi | first3 = S. | last4 = Ichii | first4 = M. | last5 = Iishi | first5 = H. | last6 = Okuda | first6 = S. | title = Values of serum carcinoembryonic antigen and elastase 1 in diagnosis of pancreatic carcinoma. | journal = Gut | volume = 25 | issue = 12 | pages = 1347-51 | month = Dec | year = 1984 | doi =  | PMID = 6569013 }}</ref><ref>{{Cite journal  | last1 = Ito | first1 = T. | last2 = Kimura | first2 = T. | last3 = Nawata | first3 = H. | title = Serum elastase 1 appears specific for cancer of the pancreatic head. | journal = Am J Gastroenterol | volume = 86 | issue = 12 | pages = 1778-83 | month = Dec | year = 1991 | doi =  | PMID = 1962622 }}</ref><ref name="Satake-1985">{{Cite journal  | last1 = Satake | first1 = K. | last2 = Kanazawa | first2 = G. | last3 = Kho | first3 = I. | last4 = Chung | first4 = Y. | last5 = Umeyama | first5 = K. | title = Evaluation of serum pancreatic enzymes, carbohydrate antigen 19-9, and carcinoembryonic antigen in various pancreatic diseases. | journal = Am J Gastroenterol | volume = 80 | issue = 8 | pages = 630-6 | month = Aug | year = 1985 | doi =  | PMID = 2411125 }}</ref>
* [[Acute pancreatitis]]<ref name="Flamion-1987">{{Cite journal  | last1 = Flamion | first1 = B. | last2 = Delhaye | first2 = M. | last3 = Horanyi | first3 = Z. | last4 = Delange | first4 = A. | last5 = Demanet | first5 = H. | last6 = Quenon | first6 = M. | last7 = Van Melsen | first7 = A. | last8 = Cremer | first8 = M. | last9 = Delcourt | first9 = A. | title = Comparison of elastase-1 with amylase, lipase, and trypsin-like immunoreactivity in the diagnosis of acute pancreatitis. | journal = Am J Gastroenterol | volume = 82 | issue = 6 | pages = 532-5 | month = Jun | year = 1987 | doi =  | PMID = 2437792 }}</ref>
* [[Coronary angioplasty]]<ref>{{Cite journal  | last1 = De Servi | first1 = S. | last2 = Mazzone | first2 = A. | last3 = Ricevuti | first3 = G. | last4 = Fioravanti | first4 = A. | last5 = Bramucci | first5 = E. | last6 = Angoli | first6 = L. | last7 = Stefano | first7 = G. | last8 = Specchia | first8 = G. | title = Granulocyte activation after coronary angioplasty in humans. | journal = Circulation | volume = 82 | issue = 1 | pages = 140-6 | month = Jul | year = 1990 | doi =  | PMID = 2163778 }}</ref>
* [[Obstructive emphysema]]<ref name="Turino-1969">{{Cite journal  | last1 = Turino | first1 = GM. | last2 = Seniorrm | first2 = BD. | last3 = Garg | first3 = S. | last4 = Keller | first4 = MM. | last5 = Levi | first5 = I. | last6 = Mandl | first6 = . | title = Serum elastase inhibitor deficiency and alpha 1-antitrypsin deficiency in patients with obstructive emphysema. | journal = Science | volume = 165 | issue = 3894 | pages = 709-11 | month = Aug | year = 1969 | doi =  | PMID = 5793975 }}</ref>
* Chronic joint disorders
* Chronic joint disorders
* [[Hemodialysis]]
* Multiple [[trauma]]
* Multiple [[trauma]]
* [[Sepsis]]
* [[Sepsis]]
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{|style="width:80%; height:100px" border="1"
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Antineutrophil cytoplasmic antibody-associated vasculitis]], [[Cardiopulmonary bypass]], [[Carotid atherosclerotic plaque development]], [[Coronary angioplasty]], [[Ischemia-reperfusion Injury]], [[Shock]], [[Systolic hypertension]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Diabetes mellitus]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 85: Line 88:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Acute pancreatitis]], [[Celiac disease]], [[Esophagogastrectomy]], [[Pancreatic cancer]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Alpha1-antitrypsin deficiency]], [[Cystic fibrosis]], [[Essential thrombocythemia]], [[Polycythemia vera]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Essential thrombocythemia]], [[Polycythemia vera]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Cardiopulmonary bypass]], [[Coronary angioplasty]], [[Esophagogastrectomy]], [[Extracorporeal detoxification]], [[Granulocyte colony-stimulating factor]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Endotoxemia]], [[Sepsis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Chronic joint disorders]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Migraine]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 117: Line 120:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Shock lung in pre-eclampsia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Pancreatic cancer]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 137: Line 140:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Acute lung injury]], [[Adult respiratory distress syndrome]], [[Alpha1-antitrypsin deficiency]], [[Cystic fibrosis]], [[Neutrophilic asthma]], [[Obstructive emphysema]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Hemodialysis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Antineutrophil cytoplasmic antibody-associated vasculitis]], [[Neutrophilic asthma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 153: Line 156:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Multiple trauma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 161: Line 164:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Exercise]], [[Oxidative stress]]
|-
|-
|}
|}


===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
{{Multicol}}
*[[Acute lung injury]]
*[[Acute pancreatitis]]
*[[Adult respiratory distress syndrome]]
*[[Alpha1-antitrypsin deficiency]]
*[[ANCA-associated vasculitis]]
*[[Cardiopulmonary bypass]]
*[[Carotid atherosclerotic plaque development]]
*[[Celiac disease]]
*[[Chronic joint disorders]]
*[[Coronary angioplasty]]
*[[Cystic fibrosis]]
{{ColBreak}}
*[[Diabetes mellitus]]
*[[Endotoxemia]]
*[[Esophagogastrectomy]]
*[[Essential thrombocythemia]]
*[[Exercise]]
*[[Extracorporeal detoxification]]
*[[Granulocyte colony-stimulating factor]]
*[[Hemodialysis]]
*[[Ischemia-reperfusion Injury]]
*[[Migraine]]
{{ColBreak}}
*[[Multiple trauma]]
*[[Neutrophilic asthma]]
*[[Obstructive emphysema]]
*[[Oxidative stress]]
*[[Pancreatic cancer]]
*[[Polycythemia vera]]
*[[Sepsis]]
*[[Shock]]
*[[Shock lung in pre-eclampsia]]
*[[Systolic hypertension]]
{{EndMultiCol}}


== References ==
== References ==
{{Reflist}}
{{Reflist|2}}
 
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}


[[Category:Blood tests]]
[[Category:Blood tests]]
[[Category:Nephrology]]
[[Category:Nephrology]]
[[Category:Infectious disease]]
 
 
{{WH}}
{{WS}}

Latest revision as of 17:39, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

  • The presence of elastase in the blood serum is caused by serine proteinase hydrolyzing elastic occuring in the endothelial cells, macrophages, and granulocytes.
Reference Range
In Plasma 60-110 ng/ml
In Pleural Effusion 480-2900 ng/ml

Causes of decreased elastase in blood serum

  • Hyperglycemia[1]
  • Prednisolone[2]

Causes of increased elastase in blood serum[3][4]

Common Causes

Causes by Organ System

Cardiovascular Antineutrophil cytoplasmic antibody-associated vasculitis, Cardiopulmonary bypass, Carotid atherosclerotic plaque development, Coronary angioplasty, Ischemia-reperfusion Injury, Shock, Systolic hypertension
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine Diabetes mellitus
Environmental No underlying causes
Gastroenterologic Acute pancreatitis, Celiac disease, Esophagogastrectomy, Pancreatic cancer
Genetic Alpha1-antitrypsin deficiency, Cystic fibrosis, Essential thrombocythemia, Polycythemia vera
Hematologic Essential thrombocythemia, Polycythemia vera
Iatrogenic Cardiopulmonary bypass, Coronary angioplasty, Esophagogastrectomy, Extracorporeal detoxification, Granulocyte colony-stimulating factor
Infectious Disease Endotoxemia, Sepsis
Musculoskeletal/Orthopedic Chronic joint disorders
Neurologic Migraine
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Shock lung in pre-eclampsia
Oncologic Pancreatic cancer
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Acute lung injury, Adult respiratory distress syndrome, Alpha1-antitrypsin deficiency, Cystic fibrosis, Neutrophilic asthma, Obstructive emphysema
Renal/Electrolyte Hemodialysis
Rheumatology/Immunology/Allergy Antineutrophil cytoplasmic antibody-associated vasculitis, Neutrophilic asthma
Sexual No underlying causes
Trauma Multiple trauma
Urologic No underlying causes
Miscellaneous Exercise, Oxidative stress

Causes in Alphabetical Order


References

  1. ↑ Stegenga, ME.; van der Crabben, SN.; Blümer, RM.; Levi, M.; Meijers, JC.; Serlie, MJ.; Tanck, MW.; Sauerwein, HP.; van der Poll, T. (2008). "Hyperglycemia enhances coagulation and reduces neutrophil degranulation, whereas hyperinsulinemia inhibits fibrinolysis during human endotoxemia". Blood. 112 (1): 82–9. doi:10.1182/blood-2007-11-121723. PMID 18316629. Unknown parameter |month= ignored (help)
  2. ↑ de Kruif, MD.; Lemaire, LC.; Giebelen, IA.; van Zoelen, MA.; Pater, JM.; van den Pangaart, PS.; Groot, AP.; de Vos, AF.; Elliott, PJ. (2007). "Prednisolone dose-dependently influences inflammation and coagulation during human endotoxemia". J Immunol. 178 (3): 1845–51. PMID 17237435. Unknown parameter |month= ignored (help)
  3. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  4. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
  5. ↑ Donnelly, SC.; MacGregor, I.; Zamani, A.; Gordon, MW.; Robertson, CE.; Steedman, DJ.; Little, K.; Haslett, C. (1995). "Plasma elastase levels and the development of the adult respiratory distress syndrome". Am J Respir Crit Care Med. 151 (5): 1428–33. doi:10.1164/ajrccm.151.5.7735596. PMID 7735596. Unknown parameter |month= ignored (help)
  6. ↑ Hughes, SF.; Cotter, MJ.; Evans, SA.; Jones, KP.; Adams, RA. (2006). "Role of leucocytes in damage to the vascular endothelium during ischaemia-reperfusion injury". Br J Biomed Sci. 63 (4): 166–70. PMID 17201205.
  7. ↑ Baines, KJ.; Simpson, JL.; Wood, LG.; Scott, RJ.; Gibson, PG. (2011). "Systemic upregulation of neutrophil α-defensins and serine proteases in neutrophilic asthma". Thorax. 66 (11): 942–7. doi:10.1136/thx.2010.157719. PMID 21785157. Unknown parameter |month= ignored (help)
  8. ↑ 8.0 8.1 Hu, H.; Johansson, BL.; Hjemdahl, P.; Li, N. (2004). "Exercise-induced platelet and leucocyte activation is not enhanced in well-controlled Type 1 diabetes, despite increased activity at rest". Diabetologia. 47 (5): 853–9. doi:10.1007/s00125-004-1378-7. PMID 15095037. Unknown parameter |month= ignored (help)
  9. ↑ Li, N.; He, S.; Blombäck, M.; Hjemdahl, P. (2007). "Platelet activity, coagulation, and fibrinolysis during exercise in healthy males: effects of thrombin inhibition by argatroban and enoxaparin". Arterioscler Thromb Vasc Biol. 27 (2): 407–13. doi:10.1161/01.ATV.0000253906.19648.ac. PMID 17138937. Unknown parameter |month= ignored (help)
  10. ↑ Carroccio, A.; Di Prima, L.; Scalici, C.; Soresi, M.; Cefalù, AB.; Noto, D.; Averna, MR.; Montalto, G.; Iacono, G. (2006). "Unexplained elevated serum pancreatic enzymes: a reason to suspect celiac disease". Clin Gastroenterol Hepatol. 4 (4): 455–9. doi:10.1016/j.cgh.2005.12.027. PMID 16616350. Unknown parameter |month= ignored (help)
  11. ↑ Yasmin, CM.; McEniery, S.; Wallace, Z.; Dakham, P.; Pulsalkar, P.; Pusalkar, K.; Maki-Petaja, MJ.; Ashby, JR.; Cockcroft, IB. (2005). "Matrix metalloproteinase-9 (MMP-9), MMP-2, and serum elastase activity are associated with systolic hypertension and arterial stiffness". Arterioscler Thromb Vasc Biol. 25 (2): 372. doi:10.1161/01.ATV.0000151373.33830.41. PMID 15556929. Unknown parameter |month= ignored (help)
  12. ↑ O'Brien, JM.; Abraham, E. (2004). "Human models of endotoxemia and recombinant human activated protein C.". Crit Care Med. 32 (5 Suppl): S202–8. PMID 15118518. Unknown parameter |month= ignored (help)
  13. ↑ Pajkrt, D.; Camoglio, L.; Tiel-van Buul, MC.; de Bruin, K.; Cutler, DL.; Affrime, MB.; Rikken, G.; van der Poll, T.; ten Cate, JW. (1997). "Attenuation of proinflammatory response by recombinant human IL-10 in human endotoxemia: effect of timing of recombinant human IL-10 administration". J Immunol. 158 (8): 3971–7. PMID 9103468. Unknown parameter |month= ignored (help)
  14. ↑ Zureik, M.; Robert, L.; Courbon, D.; Touboul, PJ.; Bizbiz, L.; Ducimetière, P. (2002). "Serum elastase activity, serum elastase inhibitors, and occurrence of carotid atherosclerotic plaques: the Etude sur le Vieillissement Artériel (EVA) study". Circulation. 105 (22): 2638–45. PMID 12045170. Unknown parameter |month= ignored (help)
  15. ↑ Clermont, G.; Lecour, S.; Cabanne, JF.; Motte, G.; Guilland, JC.; Chevet, D.; Rochette, L. (2001). "Vitamin E-coated dialyzer reduces oxidative stress in hemodialysis patients". Free Radic Biol Med. 31 (2): 233–41. PMID 11440835. Unknown parameter |month= ignored (help)
  16. ↑ 16.0 16.1 Falanga, A.; Marchetti, M.; Evangelista, V.; Vignoli, A.; Licini, M.; Balicco, M.; Manarini, S.; Finazzi, G.; Cerletti, C. (2000). "Polymorphonuclear leukocyte activation and hemostasis in patients with essential thrombocythemia and polycythemia vera". Blood. 96 (13): 4261–6. PMID 11110700. Unknown parameter |month= ignored (help)
  17. ↑ Kramer, L.; Gendo, A.; Madl, C.; Ferrara, I.; Funk, G.; Schenk, P.; Sunder-Plassmann, G.; Hörl, WH. (2000). "Biocompatibility of a cuprophane charcoal-based detoxification device in cirrhotic patients with hepatic encephalopathy". Am J Kidney Dis. 36 (6): 1193–200. doi:10.1053/ajkd.2000.19834. PMID 11096044. Unknown parameter |month= ignored (help)
  18. ↑ Reid, PT.; Donnelly, SC.; MacGregor, IR.; Grant, IS.; Cameron, E.; Walker, W.; Merrick, MV.; Haslett, C. (2000). "Pulmonary endothelial permeability and circulating neutrophil-endothelial markers in patients undergoing esophagogastrectomy". Crit Care Med. 28 (9): 3161–5. PMID 11008975. Unknown parameter |month= ignored (help)
  19. ↑ Hill, AT.; Bayley, DL.; Campbell, EJ.; Hill, SL.; Stockley, RA. (2000). "Airways inflammation in chronic bronchitis: the effects of smoking and alpha1-antitrypsin deficiency". Eur Respir J. 15 (5): 886–90. PMID 10853853. Unknown parameter |month= ignored (help)
  20. ↑ Tzourio, C.; El Amrani, M.; Robert, L.; Alpérovitch, A. (2000). "Serum elastase activity is elevated in migraine". Ann Neurol. 47 (5): 648–51. PMID 10805337. Unknown parameter |month= ignored (help)
  21. ↑ Falanga, A.; Marchetti, M.; Evangelista, V.; Manarini, S.; Oldani, E.; Giovanelli, S.; Galbusera, M.; Cerletti, C.; Barbui, T. (1999). "Neutrophil activation and hemostatic changes in healthy donors receiving granulocyte colony-stimulating factor". Blood. 93 (8): 2506–14. PMID 10194429. Unknown parameter |month= ignored (help)
  22. ↑ Haubitz, M.; Schulzeck, P.; Schellong, S.; Schulze, M.; Koch, KM.; Brunkhorst, R. (1997). "Complexed plasma elastase as an in vivo marker for leukocyte activation in antineutrophil cytoplasmic antibody-associated vasculitis". Arthritis Rheum. 40 (9): 1680–4. doi:10.1002/1529-0131(199709)40:9lt;1680::AID-ART18gt;3.0.CO;2-Q. PMID 9324023. Unknown parameter |month= ignored (help)
  23. ↑ Costello, CM.; O'Connor, CM.; Finlay, GA.; Shiels, P.; FitzGerald, MX.; Hayes, JP. (1996). "Effect of nebulised recombinant DNase on neutrophil elastase load in cystic fibrosis". Thorax. 51 (6): 619–23. PMID 8693445. Unknown parameter |month= ignored (help)
  24. ↑ Hind, CR.; Griffin, JF.; Pack, S.; Latchman, YE.; Drake, HF.; Jones, HM.; Brostoff, J.; Dormandy, TL.; Treasures, T. (1988). "Effect of cardiopulmonary bypass on circulating concentrations of leucocyte elastase and free radical activity". Cardiovasc Res. 22 (1): 37–41. PMID 3048690. Unknown parameter |month= ignored (help)
  25. ↑ Tönz, M.; Mihaljevic, T.; von Segesser, LK.; Fehr, J.; Schmid, ER.; Turina, MI. (1995). "Acute lung injury during cardiopulmonary bypass. Are the neutrophils responsible?". Chest. 108 (6): 1551–6. PMID 7497759. Unknown parameter |month= ignored (help)
  26. ↑ Rivkind, AI.; Siegel, JH.; Guadalupi, P.; Littleton, M. (1989). "Sequential patterns of eicosanoid, platelet, and neutrophil interactions in the evolution of the fulminant post-traumatic adult respiratory distress syndrome". Ann Surg. 210 (3): 355–72, discussion 372-3. PMID 2549891. Unknown parameter |month= ignored (help)
  27. ↑ Donnelly, SC.; MacGregor, I.; Zamani, A.; Gordon, MW.; Robertson, CE.; Steedman, DJ.; Little, K.; Haslett, C. (1995). "Plasma elastase levels and the development of the adult respiratory distress syndrome". Am J Respir Crit Care Med. 151 (5): 1428–33. doi:10.1164/ajrccm.151.5.7735596. PMID 7735596. Unknown parameter |month= ignored (help)
  28. ↑ Rocker, GM.; Wiseman, MS.; Pearson, D.; Shale, DJ. (1989). "Diagnostic criteria for adult respiratory distress syndrome: time for reappraisal". Lancet. 1 (8630): 120–3. PMID 2563047. Unknown parameter |month= ignored (help)
  29. ↑ Cheung, AK.; Faezi-Jenkin, B.; Leypoldt, JK. (1994). "Effect of thrombosis on complement activation and neutrophil degranulation during in vitro hemodialysis". J Am Soc Nephrol. 5 (1): 110–5. PMID 7948777. Unknown parameter |month= ignored (help)
  30. ↑ Tatsuta, M.; Yamamura, H.; Noguchi, S.; Ichii, M.; Iishi, H.; Okuda, S. (1984). "Values of serum carcinoembryonic antigen and elastase 1 in diagnosis of pancreatic carcinoma". Gut. 25 (12): 1347–51. PMID 6569013. Unknown parameter |month= ignored (help)
  31. ↑ Ito, T.; Kimura, T.; Nawata, H. (1991). "Serum elastase 1 appears specific for cancer of the pancreatic head". Am J Gastroenterol. 86 (12): 1778–83. PMID 1962622. Unknown parameter |month= ignored (help)
  32. ↑ Satake, K.; Kanazawa, G.; Kho, I.; Chung, Y.; Umeyama, K. (1985). "Evaluation of serum pancreatic enzymes, carbohydrate antigen 19-9, and carcinoembryonic antigen in various pancreatic diseases". Am J Gastroenterol. 80 (8): 630–6. PMID 2411125. Unknown parameter |month= ignored (help)
  33. ↑ Flamion, B.; Delhaye, M.; Horanyi, Z.; Delange, A.; Demanet, H.; Quenon, M.; Van Melsen, A.; Cremer, M.; Delcourt, A. (1987). "Comparison of elastase-1 with amylase, lipase, and trypsin-like immunoreactivity in the diagnosis of acute pancreatitis". Am J Gastroenterol. 82 (6): 532–5. PMID 2437792. Unknown parameter |month= ignored (help)
  34. ↑ De Servi, S.; Mazzone, A.; Ricevuti, G.; Fioravanti, A.; Bramucci, E.; Angoli, L.; Stefano, G.; Specchia, G. (1990). "Granulocyte activation after coronary angioplasty in humans". Circulation. 82 (1): 140–6. PMID 2163778. Unknown parameter |month= ignored (help)
  35. ↑ Turino, GM.; Seniorrm, BD.; Garg, S.; Keller, MM.; Levi, I.; Mandl, . (1969). "Serum elastase inhibitor deficiency and alpha 1-antitrypsin deficiency in patients with obstructive emphysema". Science. 165 (3894): 709–11. PMID 5793975. Unknown parameter |month= ignored (help)


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