Factitiously Low Amylase Values

1963 ◽  
Vol 9 (3) ◽  
pp. 296-311 ◽  
Author(s):  
Sylvan M Sax ◽  
George E Trimble
Keyword(s):  
Acute Pancreatitis ◽  
Reducing Sugars ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Good Precision ◽  
Urine Amylase ◽  
Serum And Urine

Abstract When a commercial substrate was used in the determination of serum amylase activities of patients with acute pancreatitis, results much higher than those reported by the manufacturer with similar patients were found. A failure to quantitate all of the reducing groups liberated during incubation may account for the lower results. A modified saccharogenic method has been developed, which, by increasing the ratios of starch to enzyme and copper to reducing sugars, considerably extends the range of the determination. Unequivocally elevated serum and urine amylase values can be measured without repetition of all or part of the test and with good precision.

scholarly journals Urine trypsinogen-2 as marker of acute pancreatitis

1996 ◽  
Vol 42 (5) ◽  
pp. 685-690 ◽  
Author(s):  
J Hedström ◽  
V Sainio ◽  
E Kemppainen ◽  
P Puolakkainen ◽  
R Haapiainen ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Serum Amylase ◽  
Time Resolved ◽  
Abdominal Disease ◽  
Serum Trypsinogen ◽  
Urine Amylase ◽  
Better Than

Abstract We examined the clinical utility of urine trypsinogen-2 as a marker of acute pancreatitis (AP). Fifty-nine patients with AP, 42 with acute abdominal diseases of extrapancreatic origin, and 63 without evidence of acute abdominal disease were studied. Urine trypsinogen-2 was determined by a time-resolved immunofluorometric assay. As reference methods we used serum trypsinogen-2, urine amylase, and serum amylase. The diagnostic accuracy of the markers was evaluated by receiver-operating characteristic (ROC) analysis. At admission, urine trypsinogen-2 differentiated patients with AP from controls with high accuracy. The area under the ROC curve (AUC) was 0.978, which was equal to that of serum trypsinogen-2 (0.998) and serum amylase (0.969) and significantly larger than that of urine amylase. For differentiation between severe and mild AP, urine trypsinogen-2 (0.730) was equal to serum trypsinogen-2 (0.721), and clearly better than amylase in serum and urine. These results suggest that determination of urine trypsinogen-2 is a useful test to detect AP and to evaluate disease severity.

scholarly journals Secrets, puzzles and mysteries of macroamylasemia

2020 ◽  
Vol 46 (1) ◽  
pp. 12-22
Author(s):  
N. B. Gubergrits ◽  
N. V. Byelyayeva ◽  
G. M. Lukashevich ◽  
T. L. Mozhyna
Keyword(s):  
Serum Amylase ◽  
Amylase Activity ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Normal Serum ◽  
Amylase Level ◽  
Clearance Ratio ◽  
Urine Amylase ◽  
Classical Constant

Physiological features of amylase synthesis and excretion are considered in the article, presence of other sources of amylase synthesis different from pancreas and salivary glands is emphasized. Definitions of hyperenzymemia and macroamylasemia (MAE) are given. MAE is a state characterized by presence of circulating complexes of normal serum amylase with protein or carbohydrates in blood. There are 3 types of MAE: first — classical (constant hyperamylasemia, decreased amylase level in urine, high blood concentration of macroamylase complexes); second — hyperamylasemia with slightly decreased amylase activity in urine, macroamylase/normal amylase ratio is less than in the first type; third — normal blood and urine amylase activity, low macroamylase/normal amylase ratio. Pathogenesis is explained by connection of blood amylase and acute phase protein in different inflammatory, infectious diseases, malabsorption. MAE clinical manifestations could be absent, sometimes abdominal pain is possible. Hyperamylasemia and reduced urine amylase activity are typical. MAE diagnostics means determination of macroamylase complexes in blood (chromatography, calculation of the clearance ratio of amylase and creatinine). The article presents clinical cases describing extra-pancreatic MAE in women with malignant ovarian lesions. The question of expediency of thorough diagnostic examination in asymptomatic MAE is raised, which may turn out to be a symptom of cancer. The lack of specific treatment for MAE is emphasized.

Combined serum amylase and lipase determinations for diagnosis of suspected acute pancreatitis

1993 ◽  
Vol 39 (12) ◽  
pp. 2495-2499 ◽  
Author(s):  
J P Corsetti ◽  
C Cox ◽  
T J Schulz ◽  
D A Arvan
Keyword(s):  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Test Performance ◽  
Serum Amylase ◽  
Discriminant Functions ◽  
Clinical Implementation ◽  
Sensitivity Specificity ◽  
Bivariate Approach

Abstract Serum amylase and lipase measurements are often used to diagnose acute pancreatitis. This study addresses the question of whether it is advantageous to order serum amylase and lipase tests simultaneously. We evaluated performance of the two tests separately and in combination through a retrospective study of patients for whom both amylase and lipase determinations were ordered. Initial analysis of test performance was conducted with a uniformly applied criterion based on determination of optimal sensitivity-specificity pairs. Individual tests and combinations of tests, including the "AND" and "OR" rules and discriminant functions, were examined. Only the discriminant approach demonstrated better performance than the lipase test alone. This finding was subsequently confirmed by logistic regression analysis. We conclude that ordering both tests simultaneously can be advantageous in diagnosing acute pancreatitis when a bivariate approach is used; however, this must be weighed against the difficulties associated with clinical implementation of such approaches.

scholarly journals Acute Pancreatitis with Rapid Clinical Improvement in a Child with Isovaleric Acidemia

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Elpis Mantadakis ◽  
Ioannis Chrysafis ◽  
Emmanouela Tsouvala ◽  
Athanassios Evangeliou ◽  
Athanassios Chatzimichael
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Acute Abdominal Pain ◽  
Elevated Serum ◽  
Unknown Origin ◽  
Organic Acidemia ◽  
Abdominal Ultrasonography ◽  
Isovaleric Acidemia ◽  
Intravenous Hydration ◽  
Branched Chain

Isovaleric acidemia is a rare branched-chain organic acidemia. The authors describe a 3.5-year-old girl with isovaleric acidemia and acute abdominal pain associated with bilious emesis. Elevated serum amylase and abdominal ultrasonography demonstrating an enlarged and edematous pancreas, along with the presence of peripancreatic exudates, confirmed the presence of acute pancreatitis. The patient recovered quickly with intravenous hydration, pancreatic rest, and administration of intravenous L-carnitine. Pancreatitis should be ruled out in the context of vomiting in any patient with isovaleric acidemia. Conversely, branched-chain organic acidemias should be included in the differential diagnosis of any child with pancreatitis of unknown origin.

scholarly journals Abdominal pain and a raised amylase? It’s not always pancreatitis…

2013 ◽  
Vol 12 (3) ◽  
pp. 163-165
Author(s):  
IO Oluwatowoju ◽  
◽  
EO Abu ◽  
G Lawson ◽  
◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Epigastric Pain ◽  
Elevated Serum ◽  
High Serum ◽  
Amylase Level ◽  
Serum Amylase Level ◽  
Heavy Alcohol ◽  
Heavy Alcohol Consumption ◽  
History Of

We report the case of a 72 year old man with a history of COPD and heavy alcohol consumption who was initially diagnosed with acute pancreatitis based on a presentation with epigastric pain and elevated serum amylase. Review of his notes revealed several previous similar admissions and extensive normal investigations apart from persistently elevated amylase. Further analysis showed evidence of macroamylasaemia which accounted for the apparently high serum amylase level.

scholarly journals Risk Factors of Acute Pancreatitis in Oral Double Balloon Enteroscopy

2016 ◽  
Vol 59 (3) ◽  
pp. 84-90 ◽  
Author(s):  
Marcela Kopáčová ◽  
Jan Bureš ◽  
Stanislav Rejchrt ◽  
Jaroslava Vávrová ◽  
Jolana Bártová ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Double Balloon Enteroscopy ◽  
Serum Lipase ◽  
Balloon Enteroscopy ◽  
Double Balloon ◽  
Laboratory Markers ◽  
Before And After ◽  
Hs Crp ◽  
Urine Amylase

Double balloon enteroscopy (DBE) was introduced 15 years ago. The complications of diagnostic DBE are rare, acute pancreatitis is most redoubtable one (incidence about 0.3%). Hyperamylasemia after DBE seems to be a rather common condition respectively. The most probable cause seems to be a mechanical straining of the pancreas. We tried to identify patients in a higher risk of acute pancreatitis after DBE. We investigated several laboratory markers before and after DBE (serum cathepsin B, lactoferrin, E-selectin, SPINK 1, procalcitonin, S100 proteins, alfa-1-antitrypsin, hs-CRP, malondialdehyde, serum and urine amylase and serum lipase). Serum amylase and lipase rose significantly with the maximum 4 hours after DBE. Serum cathepsin and procalcitonin decreased significantly 4 hours after DBE compared to healthy controls and patients values before DBE. Either serum amylase or lipase 4 hours after DBE did not correlate with any markers before DBE. There was a trend for an association between the number of push-and-pull cycles and procalcitonin and urine amylase 4 hours after DBE; between procalcitonin and alfa-1-antitrypsin, cathepsin and hs-CRP; and between E-selectin and malondialdehyde 4 hours after DBE. We found no laboratory markers determinative in advance those patients in a higher risk of acute pancreatitis after DBE.

Determination of amylase activity in serum by using a wheat germ inhibitor with the Du Pont aca.

1986 ◽  
Vol 32 (8) ◽  
pp. 1539-1541 ◽  
Author(s):  
D A Lacher ◽  
M B Harize
Keyword(s):  
Acute Pancreatitis ◽  
Wheat Germ ◽  
Serum Amylase ◽  
Amylase Activity ◽  
Reference Interval ◽  
Pancreatic Amylase ◽  
Wheat Germ Extract ◽  
Rapid Procedure ◽  
Assay Conditions

Abstract A rapid procedure for determining salivary- and pancreatic-type amylase (EC 3.2.1.1) in serum by incorporating a wheat germ inhibitor (from Triticum aestivum) was developed for the Du Pont aca IV analyzer. Under optimal assay conditions, activities of salivary and pancreatic amylase were inhibited by 93% and 19%, respectively. The 95% central reference interval for the percentage of inhibition of serum amylase was 38-84%. Patients with acute pancreatitis showed less than 26% inhibition of amylase after addition of the wheat germ extract, reflecting the prevalence of pancreatic-type amylase in this disorder.

Acute painless pancreatitis as an unusual presentation of leptospirosis in a low-incidence country

2020 ◽  
Vol 13 (8) ◽  
pp. e234988
Author(s):  
Ami Schattner ◽  
Ina Dubin ◽  
Yair Glick ◽  
Elizabeth Nissim
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Liver Enzymes ◽  
Elevated Serum ◽  
Kidney Injury ◽  
C Reactive Protein ◽  
Diagnostic Challenge ◽  
Reactive Protein ◽  
Animal Contact ◽  
Low Incidence

A healthy, urban-dwelling man presented with lassitude, jaundice without increased liver enzymes or obstructive features on imaging, brief acute kidney injury, leucocytosis with near-normal C reactive protein and markedly increased serum amylase and lipase. Leptospirosis was not considered for 10 days because of the low incidence of the disease in the country, absent animal contact and physicians’ low index of suspicion. Presentation without fever and without the commonly associated abdominal pain, myalgia, headache, thrombocytopaenia or elevated serum creatine kinase added to the diagnostic challenge. Once an infectious cause of acute pancreatitis was contemplated, leptospirosis was immediately sought and diagnosed by PCR of urine and microscopic agglutination test, and he fully recovered on ceftriaxone. Physicians in countries with a low incidence of leptospirosis should be more aware of the possibility of the disease even when several key features such as fever or pain are missing and the patient has a rare infectious acute pancreatitis.

A Cause of Misleading Serum Amylase Concentrations in Acute Pancreatitis

1977 ◽  
Vol 22 (2) ◽  
pp. 151-153 ◽  
Author(s):  
L. A. Donaldson ◽  
W. McIntosh
Keyword(s):  
Acute Pancreatitis ◽  
Serum Level ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Serial Dilutions

The operative discovery of acute pancreatitis associated with gross hyperlipidaemia but a normal or high elevated serum amylase concentration has been described. We report a case of acute pancreatitis in which serial dilutions of serum resulted in a 338 per cent rise in the serum amylase concentrations. The importance of appreciating this effect of hyperlipidaemia on the serum level measurements in patients with acute pancreatitis is re-emphasised.

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