Hyperamylasaemia and/or hyperlipasaemia: incidence and underlying causes in hospitalized patients with non-pancreatic diseases.
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.
Lankisch
Paul Georg
PG
Clinic for General Internal Medicine, Medical Centre, Municipal Clinic of Lüneburg, Lüneburg, Germany. paulgeorg.lankisch@t-online.de
Doobe
Christian
C
Finger
Thorsten
T
Lübbers
Heiko
H
Mahlke
Reiner
R
Brinkmann
Gisbert
G
Klöppel
Günter
G
Maisonneuve
Patrick
P
Lowenfels
Albert B
AB
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
D008049:Lipase