title: Elevated serum amylase in patients with chronic pancreatitis: acute attack or macroamylasemia?
abstract: OBJECTIVE
  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.affiliation: Department of Internal Medicine, Donetsk National Medical University, Pr. Grinkevicha, 8-3, 83001 Donetsk, Ukraine. Electronic address: nbg@pisem.net.
authors.forename: Natalya
authors.initials: N
authors.lastname: Gubergrits
authors.affiliation: Department of Internal Medicine, Donetsk National Medical University, Pr. Grinkevicha, 8-3, 83001 Donetsk, Ukraine.
authors.forename: Oksana
authors.initials: O
authors.lastname: Golubova
authors.affiliation: Department of Internal Medicine, Donetsk National Medical University, Pr. Grinkevicha, 8-3, 83001 Donetsk, Ukraine.
authors.forename: Galina
authors.initials: G
authors.lastname: Lukashevich
authors.affiliation: Department of Internal Medicine, Donetsk National Medical University, Pr. Grinkevicha, 8-3, 83001 Donetsk, Ukraine.
authors.forename: Pavlo
authors.initials: P
authors.lastname: Fomenko
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000465:Algorithms; D000681:Amylases / Q000097:blood* / Q000737:chemistry; D002908:Chronic Disease; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000097:blood*; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D010195:Pancreatitis / Q000201:enzymology*; D011092:Polyethylene Glycols; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D011092:Polyethylene Glycols; D008049:Lipase; D000681:Amylases
keywords: Acute exacerbation; Chronic pancreatitis; Macroamylase; Serum amylase; Serum lipase