Elevated serum amylase activity is commonly seen in acute pancreatitis and salivary gland inflammation, but also rarely seen in a benign phenomenon, macroamylasemia, that does not require treatment.
Macroamylasemia was diagnosed on the basis of these findings.
The prevalence of macroamylasemia has been estimated at 1% in normal amylasemic patients and 2.5% in hyperamylasemic patients (3).
An elevated level may reflect one of several medical conditions including: pancreatitis; perforated peptic ulcer; torsion of an ovarian cyst; strangulation of the ileus; mesenteric ischemia; macroamylasemia; appendicitis; ascites; pancreatic pseudocysts; acute cholecystitis; ruptured ectopic pregnancy; peritonitis; burns; diabetic ketoacidosis; cancer of the lung , esophagus, or ovary; alcohol use; prostate tumors; bulimia and anorexia nervosa; mumps; and, cystic fibrosis.
Amylase clearance testing may be used to differentiate between macroamylasemia and pancreatitis.
Hyperamylasemia has been noted in conditions like malignancies (gastric, ovarian neoplasm, multiple myeloma, lung, pheochromocytoma), perforated hollow viscus, ruptured tubal pregnancy, opiate administration, cardiac failure, diabetes ketoacidosis, post cardiac surgery, salivary gland disorders, renal failure, trauma bulimea, anorexia nervosa, familial hyperamylasemia and macroamylasemia
Serum amylase may also be increased in extra-abdominal states, such as pathologies of the salivary gland, impaired renal function, pneumonia, or such asymptomatic conditions as macroamylasemia
(in which amylase is bound to immunoglobulins or polysaccharides to form large molecular weight complexes) (4, 7).
We suspected and were able to show that the patient had "macroamylasemia
"--an uncommon but, fortunately, completely benign condition.
Previous publications have calculated an incidence of macroamylasemia
of 0.98% in patients with typical amylase concentrations and 2.56% in those with hyperamylasemia.
(15) described simultaneous macrolipasemia and macroamylasemia in association with poly-IgA.
Unusual association of macroamylasemia and hyperlipasemia: report of two cases.
Demonstration of macroamylasemia
by polyethylene glycol (PEG) precipitation requires correct PEG concentration [Letter].