Elevated amylase and/or lipase levels greater than three times the upper limit of normal in an appropriate clinical setting are suggestive of pancreatitis. There are several non-pancreatic related clinical situations that lead to elevation of these enzymes. One should be careful in interpretation of these test results. Routine testing of these enzymes for evaluation of abdominal pain should be avoided. Persistent elevations should be evaluated by cross-sectional imaging and preferably secretin enhanced MRCP. Endoscopic therapies should not be routinely performed in those with borderline elevation of enzymes. Pancreatitis can occur with normal or mild degree of amylase and lipase elevations, and thus, cross-sectional imaging can be helpful. Severity of disease does not correlate with the degree of elevations of amylase and/or lipase. Contrary to common practice the trend of the enzyme elevation does not correlate with the clinical course and should not guide clinical decision making.
- Pancreatic enzymes
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Rajca, B., Guda, N.M. (2016). Elevated Amylase and Lipase: Physiology Including Non-pancreatitis related Elevations. In: Dua, K., Shaker, R. (eds) Pancreas and Biliary Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-28089-9_1
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Print ISBN: 978-3-319-28087-5
Online ISBN: 978-3-319-28089-9