Which of the following is a laboratory finding commonly associated with pancreatitis?

• A. Decreased white blood cell count
• B. Normal bilirubin
• C. Low amylase
• D. Elevated pancreatic enzymes

Answer: (D)

When the pancreas is inflamed, its enzymes leak into the bloodstream, so pancreatic enzymes in the blood rise. The most commonly used markers are amylase and lipase, with lipase being more specific to pancreatic injury and typically remaining elevated longer than amylase. This makes elevated pancreatic enzymes the hallmark lab finding for pancreatitis.

Decreased white blood cell count is not typical; pancreatitis usually causes leukocytosis from the inflammatory response. Bilirubin can be normal or elevated depending on whether there is associated biliary obstruction or other complications, so normal bilirubin isn’t as characteristic. Low amylase would be opposite of what is usually seen, since amylase (and lipase) tend to be increased in pancreatitis.