Korean J Pancreas Biliary Tract.  2017 Jul;22(3):103-113. 10.15279/kpba.2017.22.3.103.

Evaluation of Asymptomatic Hyperamylasemia and Hyperlipasemia

• Lee SH

• KMID: 2448603
• DOI: http://doi.org/10.15279/kpba.2017.22.3.103

Abstract

There are increasing number of cases of serum amylase and lipase levels being examined as part of health screening, but the clinical significance of these amylase and lipase levels is unclear. When the clinicians encounter patients with elevated pancreatic enzymes, the most common causes such as acute pancreatitis, hepatic or renal dysfunction should be ruled out first by thorough history taking, physical examination, and laboratory tests. Further tests including abdominal ultrasonography or computed tomography, lipid profile, tumor marker, isoenzyme, and calculation of amylase-to-creatinine clearance ratio or polyethylene glycol precipitation test should be performed to exclude other causes. If the pancreatic enzymes are continuously elevated through repeated tests without any apparent etiology, the diagnosis is made with chronic non-pathological pancreatic hyperenzymemia (CNPH). Magnetic resonance cholangiopancreatography is very useful and important modality for the patients with CNPH but the clinical significance of magnetic resonance cholangiopancreatography with secretin stimulation is still unclear. They can be evaluated through endoscopic ultrasonography with preference but it is less suitable for follow-up. Individualized approaches should be made after considering the need for active treatment or periodic follow-up for the benign pancreatic diseases associated with CNPH. It is difficult to conclude until more long-term data are reported because there are only limited number of researches and consensus on the range of tests to be performed for diagnosis, clinical significance of benign findings and end of follow-up in patients with CNPH.

Keyword

Pancreas; Amylase; Lipase

MeSH Terms

Amylases
Cholangiopancreatography, Magnetic Resonance
Consensus
Diagnosis
Endosonography
Follow-Up Studies
Humans
Hyperamylasemia*
Lipase
Mass Screening
Pancreas
Pancreatic Diseases
Pancreatitis
Physical Examination
Polyethylene Glycols
Secretin
Ultrasonography
Amylases
Lipase
Polyethylene Glycols
Secretin