From the Guidelines
High lipase levels in the blood typically indicate pancreatic inflammation or damage, and if you have high lipase, you should consult a healthcare provider promptly for proper evaluation, as the most recent and highest quality study suggests that serum lipase is considered a more reliable diagnostic marker of acute pancreatitis than serum amylase 1.
Causes and Treatment
High lipase levels can be caused by various conditions, including pancreatitis, pancreatic cancer, kidney disease, or certain medications. Treatment depends on the underlying cause, and for acute pancreatitis, it usually involves:
- Fasting to rest the pancreas
- IV fluids
- Pain management with medications like morphine or hydrocodone
- Treating the underlying cause (such as gallstones or alcohol use) For chronic conditions, lifestyle modifications are important, including:
- Avoiding alcohol
- Following a low-fat diet
- Staying hydrated
- Stopping smoking
Diagnosis and Testing
Your doctor may order additional tests like abdominal imaging or endoscopic procedures to determine the exact cause of high lipase levels. Lipase is an enzyme produced primarily by the pancreas that helps digest fats, and elevated levels occur when pancreatic cells are damaged and release more lipase into the bloodstream. Normal lipase levels typically range from 0-160 U/L, though reference ranges vary between laboratories.
Key Points to Consider
- Serum lipase is a more reliable diagnostic marker of acute pancreatitis than serum amylase 1
- Treatment depends on the underlying cause of high lipase levels
- Lifestyle modifications are important for managing chronic conditions
- Additional testing may be necessary to determine the exact cause of high lipase levels Some key points to consider when evaluating high lipase levels include:
- The diagnosis of acute pancreatitis should be established within 48 hours of admission, based on compatible clinical features and elevations in amylase or lipase levels 1
- Elevations in lipase levels greater than 3 times the upper limit of normal, in the absence of renal failure, are most consistent with acute pancreatitis 1
- Lipase levels can be elevated in non-pancreatic diseases, such as renal disease, appendicitis, acute cholecystitis, chronic pancreatitis, bowel obstruction, etc. 1
From the Research
High Lipase Levels
- High lipase levels can be an indicator of acute pancreatitis, as seen in patients with abdominal pain and elevated lipase values 2.
- Lipase has largely replaced amylase in terms of diagnostic value for acute pancreatitis, due to its improved sensitivity and specificity 3.
- Serum lipase is now the preferred test for diagnosing acute pancreatitis, particularly in alcohol-induced cases, as it has a wider diagnostic window than amylase 4.
Causes of High Lipase Levels
- High lipase levels can be caused by various factors, including cholecystitis, renal transplant, and immune checkpoint inhibitors 2, 5.
- Immune checkpoint inhibitors can cause pancreatitis as a rare immune-related adverse event, with early signs including elevation of lipase and amylase 5.
Diagnosis and Management
- The diagnosis of acute pancreatitis requires the presence of at least two of the three diagnostic criteria: characteristic abdominal pain, elevated serum amylase or lipase, and radiological evidence of pancreatitis 4.
- Management of acute pancreatitis can include interventions such as IV fluids, holding the agent, antibiotics, and steroids, with the National Comprehensive Cancer Network Guidelines recommending intervention for moderate to severe pancreatitis 5.
- Early prophylactic treatment with imipenem can reduce the rate of septic complications in patients with severe pancreatitis 6.