Elevated serum amylase in patients with chronic pancreatitis: acute attack or macroamylasemia?

Abstract

BACKGROUND AND AIM:

Asymptomatic patients with chronic pancreatitis not infrequently have elevated concentrations of amylase, even though detailed examination reveals no indication of an acute exacerbation.

METHODS:

One hundred and eighty-six consecutive patients with chronic pancreatitis were examined clinically and, if indicated, by ultrasonography and computed tomography. In addition, all patients underwent determination of serum amylase and serum lipase as well as amylase/creatinine clearance, followed as required by a polyethylene glycol test and/or chromatography to demonstrate macroamylase.

RESULTS:

Twenty (11%) of the 186 patients had macroamylasemia, and 15 of these 20 had hyperamylasemia. In the remaining five cases the serum amylase levels were within the normal range.

CONCLUSIONS:

Patients with asymptomatic chronic pancreatitis and hyperamylasemia should first be investigated for macroamylasemia, before initiating any costly or complex procedures in the attempt to demonstrate a clinically silent or only mildly symptomatic attack of their disease.

• Authors: Natalya Gubergrits, Oksana Golubova, Galina Lukashevich, Pavlo Fomenko
• Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] (Pancreatology) 2014 Mar-Apr Vol. 14 Issue 2 Pg. 114-6 ISSN: 1424-3911 [Electronic] Switzerland
• PMID: 24650965 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Chemical References

• Polyethylene Glycols
• Lipase
• Amylases

Topics

• Acute Disease
• Adult
• Aged
• Algorithms
• Amylases (blood, chemistry)
• Chronic Disease
• Female
• Humans
• Hyperamylasemia (blood)
• Lipase (blood)
• Male
• Middle Aged
• Molecular Weight
• Pancreatitis (enzymology)
• Polyethylene Glycols
• Prospective Studies
• Young Adult