Abstract
Determination of serum amylase activity in 100 consecutive patients admitted to an alcohol detoxification unit revealed hyperamylasemia in 39 cases. Further clinical evaluation of 15 of the 39 alcoholic patients with hyperamylasemia was unremarkable except for bilateral enlargement of the parotid glands in two cases. Nine of the 15 patients demonstrated markedly low amylase to creatinine clearance ratio; however, macroamylase complexes were not detected in the sera of any patients. Serum isoamylase separation revealed that the mean salivary isoamylase for the 15 alcoholic patients was significantly (P<0.05) elevated as compared to the control values. Individually, the salivary-type isoamylase was clearly elevated in ten patients while pancreatic type isoamylase was elevated in four. These data indicate that elevated serum amylase activity occurs frequently in alcoholic patients. Hyperamylasemia in a large number of alcoholic patients is nonpancreatic in origin and may be related to the injurious effect of ethanol on salivary glands and other tissues.
Similar content being viewed by others
References
Salt WB, Schenker S: Amylase—its clinical significance. A review of the literature. Medicine 55:269–289, 1976
Christiansen H: Preliminary report on serum amylase in chronic alcoholics. Hospitalstidende 79:79–83, 1963
Carter JS: Serum amylase findings in chronic alcoholic patients with acute severe abdominal symptoms. Ann Surg 122:302–308, 1943
Domzalski CA, Wedge BM: Elevated serum amylase in alcoholics. Am J Clin Pathol 18:43–47, 1948
Berk JE, Fridhandler K, Webb, SF: Does hyperamylasemia in drunken alcoholics signify pancreatitis. Am J Gastroenterol 71:557–562, 1979
Ceska M, Birath K, Brown B: A new and rapid method for the clinical determination of alpha-amylase activities in human serum and urine. Clin Chim Acta 26:437–444, 1969
Ceska M, Brown B, Birath K: Ranges of alpha-amylase activities in human serum and urine and correlations with some other alpha-amylase methods. Clin Chim Acta 26:445–453, 1969
Levitt MD, Rapoport M, Cooperband SR: Renal clearance of amylase in renal insufficiency, acute pancreatitis, and macroamylasemia. Ann Intern Med 71:919–925, 1969
Fridhandler L, Berk JE, Ueda M: Macroamylasemia: Rapid detection method. Clin Chim 17:423–426, 1971
Levitt MD, Ellis C, Engel RR: Isoelectric focussing studies on human serum and tissue isoamylase. J Lab Clin Med 90:141–152, 1977
Vogel, WC, Zieve L: A rapid and sensitive tubidimetric method for serum lipase based on differences between the lipase of normal and pancreatic serum. Clin Chem 9:168–181, 1963
Nossel HL: The effect of morphine on the serum and urinary amylase and the sphincter of Oddi—with some preliminary observations on the effect of alcohol on the serum amylase and the sphincter of Oddi. Gastroenterology 29:409–416, 1955
Myhre J, Nesbitt S: Alcohol and pancreatitis: Serum amylase determinations in normal individuals following ingestion of alcohol. J Lab Clin Med 34:844–845, 1949
Fisher AJG, Wardle N, van Oldenborg M, et al: The effect of acute alcoholism on the serum amylase of normal persons. S Afr Med J 39:673–676, 1976
Bonnin H, Morelti G, Geyer A: Les grosses parotides des cirrhoses alcooliques. Presse Med 62:1449–1451, 1954
Wolfe SJ, Summerskill WHS, Davidson CS: Parotid swelling, alcoholism and cirrhosis. N Eng J Med 256:491–494, 1957
Perec CJ, Clener D, Tiscornia OM, et al: Effects of chronic ethanol administration on the autonomic innervation of salivary glands, pancreas and heart. Am J Gastroenterol 72:46–59, 1979
Morris GCR: Pathological physiology of salivary glands.In Handbook of Physiology, Vol II, Section 6, CF Code (ed). Baltimore. Williams and Wilkins; pp 679–703, 1967
Martin S, Pangborn RM: Human parotid secretion in response to ethyl alcohol. J Dent Res 50:485–490, 1971
MacGregor IL, Zakim D: A cause of hyperamylasemia associated with chronic liver disease. Gastroenterology 72:519–523, 1977
Warshaw AL, Bellini CA, Lee KH: Electrophoretic identification of an isoenzyme of amylase which increases in serum in liver diseases. Gastroenterology 70:572–576, 1976
Berk JE, Shimamur J, Fridhandler L: Amylase changes in disorders of the lung. Gastroenterology 74:1313–1317, 1978
Warshaw AL, Lee KH: Characteristic alterations of serum isoenzymes of amylases in diseases of liver, pancreas, salivary gland, lung and genitalia. J Surg Res 22:362–369, 1977
Otsuki M, Saeki S, Yuu H, et al: Amylase and the Lung. Int Congr Ser No 369, Amsterdam, Excerpta Medica Foundation, p 67, 1975
Morrissey R, Berk JE, Fridhandler L, et al: The nature and significance of hyperamylasemia following operation. Ann Surg 180:67–71, 1974
Harada K, Kitamura M, Ikenago T: Isoenzyme study on postoperative transient hyperamylasemia. Am J Gastroenterol 61:212–216, 1974
Warshaw AL, Feller ER, Lee KH: On the cause of raised serum amylase in diabetic ketoacidosis. Lancet 1:929–931, 1977
Levitt MD, Cooperband SR: Hyperamylasemia from the binding of serum amylase by an II S IgA globulin. N Engl J Med 278:474–479, 1968
Berk JE, Fridhandler L, Montgomery K: Simulation of macroamylasemia by salivary type (‘S’ type) hyperamylasemia. Gut 14:726–729, 1973
Duane W, Frerichs R, Levitt MD: Distribution turnover, and mechanism of renal excretion of amylase in the baboon. J Clin Invest 50:156–165, 1971
Duane WC, Frerichs R, Levitt MD: Simultaneous study of the metabolic turnover and renal excretion of salivary amylase-125I and pancreatic amylase-131I in the baboon. J Clin Invest 51:1504–1513, 1972
Fridhandler L, Berk JE, Ueda M: Isolation and measurement of pancreatic amylase in human serum and urine. Clin Chem 18:1493–1497, 1972
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dutta, S.K., Douglass, W., Smalls, U.A. et al. Prevalence and nature of hyperamylasemia in acute alcoholism. Digest Dis Sci 26, 136–141 (1981). https://doi.org/10.1007/BF01312231
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01312231