title: Hyperamylasaemia and/or hyperlipasaemia: incidence and underlying causes in hospitalized patients with non-pancreatic diseases.
abstract: OBJECTIVE
  There are no recommendations on how to proceed in patients with increased pancreatic enzyme activities but non-pancreatic diseases. The objective of this study was to investigate prospectively in a general medical hospital the incidence, causes and clinical impact of hyperamylasaemia and/or hyperlipasaemia in these patients.
  
  
  METHODS
  During a 4-month period in 2004, amylase and lipase activities were measured in all patients (n, 1765) admitted to the Department of Internal Medicine of the Municipal Clinic of Lüneburg, Germany. Patients with increased enzyme activities underwent abdominal ultrasonography and, if inconclusive, other imaging procedures.
  
  
  RESULTS
  Amylase and/or lipase activities were increased in 140 (8%) patients with non-pancreatic diseases: amylase in 29 cases (21%) and 1 case (1%)<3 and>3 times the upper limit of normal, respectively, lipase in 120 cases (86%) and 6 cases (4%)<3 and>3 times, respectively. In 53 (38%) patients no further imaging studies could be performed. In the remaining 87 patients amylase was increased in 18 patients (21%) and lipase in 3 patients (3%). The pancreas was normal on imaging procedures in 77 (89%) patients and abnormal in 10 (11%) (chronic pancreatitis: 4, small cystic lesions: 6). The cystic lesions were mostly located in the pancreas head, probably corresponding to branch-duct intraductal papillary mucinous neoplasm.
  
  
  CONCLUSIONS
  Increased pancreatic enzyme activities occur in 8% of hospitalized patients with non-pancreatic diseases, but pancreatic abnormalities will be found in only a few (11%), which are unlikely to need further investigation or therapy. Therefore, routine analysis of amylase or lipase activities in patients with non-pancreatic diseases is not indicated.
authors.affiliation: Clinic for General Internal Medicine, Medical Centre, Municipal Clinic of Lüneburg, Lüneburg, Germany. paulgeorg.lankisch@t-online.de
authors.forename: Paul Georg
authors.initials: PG
authors.lastname: Lankisch
authors.forename: Christian
authors.initials: C
authors.lastname: Doobe
authors.forename: Thorsten
authors.initials: T
authors.lastname: Finger
authors.forename: Heiko
authors.initials: H
authors.lastname: Lübbers
authors.forename: Reiner
authors.initials: R
authors.lastname: Mahlke
authors.forename: Gisbert
authors.initials: G
authors.lastname: Brinkmann
authors.forename: Günter
authors.initials: G
authors.lastname: Klöppel
authors.forename: Patrick
authors.initials: P
authors.lastname: Maisonneuve
authors.forename: Albert B
authors.initials: AB
authors.lastname: Lowenfels
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000097:blood*; D015994:Incidence; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology
chemical_list: D008049:Lipase