Home

Warning: strtotime() [function.strtotime]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'Europe/Berlin' for 'CEST/2.0/DST' instead in /home/sharedre/public_html/chronolab.com/point-of-care/libraries/joomla/utilities/date.php on line 56

Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'Europe/Berlin' for 'CEST/2.0/DST' instead in /home/sharedre/public_html/chronolab.com/point-of-care/libraries/joomla/utilities/date.php on line 198

Amylase - total

Clinical significance

Determination of the catalytic concentration of α-amylase is used in the diagnosis and follow-up of therapeutic success in acute pancreatitis, and for detection of salivary gland inflammation.


SERUM

1) Physiologic changes in the catalytic concentration of α-amylase in serum

The catalytic concentration of α-amylase is very low in newborns in the first two months. Toward the end of the first year of life, the level of α-amylase reaches the level found in adults. In the blood of healthy individuals, the catalytic activity of α-amylase is fairly constant.
The catalytic concentration of a-amylase in serum decreases upon the administration of glucose, fructose, glucagon or insulin.

2) Pathologic changes in the catalytic concentration of α-amylase in serum
A) Increased values of the catalytic concentration of α-amylase in serum are found in:
a) Pancreatic disease:

• acute exacerbation of chronic pancreatitis,
• acute pancreatitis ((peak values reached at 5-12 h from the onset of acute episode, where after they return to normal),
• bronchial carcinoma,
• calculous obstruction of the pancreatic duct,
• cholecystitis,
• corticoid therapy may occasionally precipitate the development of acute pancreatitis,
• familial pancreatitis,
• macroamylasemia (a macromolecule of a relative molecular mass of 200 000, which is not eliminated in urine),
• ovary carcinoma,
• peptic ulcer perforation (especially if the pancreas is also involved),
• post-gastrectomy state,
• scorpion sting,
• use of opiates, codeine and methylcholine (due to the spasm of the pancreatic duct sphincter).
b) Salivary gland disease:
• calculous obstruction of the salivary gland duct,
• mumps,
• parotitis phlegmonosa.
c) Other disease:
• acquired immune deficiency syndrome (aids) ,
• acute appendicitis,
• acute renal failure,
• anorexia nervosa,
• benign prostatic hypertrophy,
• carcinoma of the lungs,
• carcinoma of the pancreas ,
• children with pancreatitis due to steroid therapy,
• chronic alcoholism,
• chronic malabsorption with atrophy of intestinal villi,
• chronic renal failure,
• cysts and pseudocysts of the pancreas,
• diabetic acidosis
• extrahepatic obstruction,
• female patients with hyperlipoproteinemia type IV taking oral contraceptives
• hyperlipoproteinemia type I and V (during abdominal pain),
• infectious mononucleosis,
• intestinal obstruction (values of >1850 U/L point to impacted or necrotic intestine),
• malabsorptions,
• methanol intoxication,
• ovary carcinoma,
• peritonitis (amylase values <405 U/L without signs of pancreatitis),
• renal artery embolism,
• renal diseases (if oliguria is present, serum amylase may rise to 'diagnostic values'),
• severe accidental hypothermia (acute pancreatitis develops in some 10% of patients),
• viral hepatitis

B) Decreased values of the catalytic concentration of α-amylase in serum are found in:
• acute and subacute liver necrosis,
• carcinoma of the pancreas ,
• cholecystitis (some cases),
• congestive cardiac decompensation (some cases),
• diabetes mellitus,
• eclampsia,
• gestational toxemia,
• hepatitis,
• intoxication with carbon tetrachloride, barbiturates or arsenic,
• necrotic pancreatitis (rapid massive destruction of the pancreas),
• protein malnutrition,
• severe burns,
• severe thyrotoxicosis,
• therapy with propylthiouracil,
• toxic hepatitis.


URINE

1) Physiologic changes in the catalytic activity of α-amylase

Normal rate of α-amylase excretion is 127-1344 U/L.

2) Pathologic changes in the catalytic activity of α-amylase

During an episode of acute pancreatitis, normal values of a-amylase can be obtained in case of massive pancreatic destruction.
A) Increased values of the catalytic concentration of α-amylase are found in:
a) acute pancreatitis (very high values are found within 24 hours),
• carcinoma of the lungs,
• carcinoma of the pancreas ,
• chronic renal failure.
• extrahepatic obstruction,
• pancreatic cyst and pseudocyst,
b) Benign prostatic hypertrophy

B) Moderately increased values of the catalytic concentration of α-amylase are found in:
• carcinoma of the pancreas ,
• common biliary duct calculi,
• duodenal ulcer perforation into the pancreas,
• mumps.
• parotitis phlegmonosa
• salivary gland disease,
• salivary gland ducts calculi,

C) Decreased values of the catalytic concentration of α-amylase are found in:
• liver disease (some cases),
• renal disease (some cases).