Chronic asymptomatic pancreatic hyperenzymemia is a benign condition in only half of the cases: a prospective study.
OBJECTIVE
Prospectively to evaluate patients with chronic asymptomatic pancreatic hyperenzymemia in order to identify possible pancreatic and non-pancreatic diseases.


METHODS
Seventy-five asymptomatic subjects with long-standing pancreatic hyperenzymemia (45 M, 30 F; mean age+/-SD 51.5+/-16.0 years, range 19-78 years, mean duration+/-SD of pancreatic hyperenzymemia 14.7+/-7.0 months, range 7-34 months) and normal ultrasonographic evaluation were included in this study. The subjects enrolled were carefully interviewed and prospectively evaluated. All patients underwent blood screening. An additional abdominal ultrasound was also carried out and, if considered necessary, other imaging and endoscopic evaluation procedures were used.


RESULTS
The follow-up of the patients after enrollment in the study was 3.3+/-1.8 years (mean+/-SD). In 38 patients (50.7%), pancreatic or extrapancreatic disease was diagnosed: 20 patients had chronic pancreatitis, 1 had autoimmune chronic pancreatitis, 1 had a benign cyst of the pancreas, 2 had serous cystadenomas, 5 had an intraductal papillary mucinous tumor of the pancreas, 3 had a ductal pancreatic adenocarcinoma, 4 patients had chronic viral hepatitis, and 2 had Crohn's disease. In 37 subjects (49.3%), no pancreatic or extrapancreatic diseases were found (3 subjects had macroamylasemia, 3 had familial hyperenzymemia, 31 had chronic non-pathological pancreatic hyperenzymemia).


CONCLUSIONS
Subjects having an increase of either amylase or lipase serum levels should undergo a thorough diagnostic work-up prior to establishing the existence of chronic non-pathological pancreatic hyperenzymemia.
Pezzilli
Raffaele
R
Department of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, Bologna, Italy. raffaele.pezzilli@aosp.bo.it
Morselli-Labate
Antonio Maria
AM
Casadei
Riccardo
R
Campana
Davide
D
Rega
Daniela
D
Santini
Donatella
D
Calculli
Lucia
L
Corinaldesi
Roberto
R
D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood; D019540:Area Under Curve; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000201:enzymology*; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000201:enzymology*; D011446:Prospective Studies; D012372:ROC Curve
D008049:Lipase; D000681:Amylases