AMYLASE - plasma or serum

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Specimen: 5 mL blood in lithium heparin or plain tube.

Method: Spectrophotometry.

Reference Interval: Method dependent; racial differences have been reported. Consult pathologist.

Application: Clinical suspicion of acute pancreatitis. Lipase is the preferred test.

Interpretation: Very high levels are found with acute pancreatitis, however lipase is a more sensitive and specific indicator of this disorder. A normal amylase level does not exclude acute pancreatitis. The test is not specific, with very high levels being found in pancreatic pseudocyst, perforated duodenal ulcer and upper small bowel obstruction; moderately high levels are found frequently in other acute abdominal conditions. High levels are also found in acute parotitis and macroamylasaemia, a clinically insignificant disorder described in 1.5% of (non-alcoholic) hospitalised adult patients. Some laboratories also offer an assay for the pancreatic isoenzyme, which improves the specificity of the test. See also LIPASE .

Reference: Rosalki SB. Enzyme 1988; 39: 95-109. Clavé P et al. Clin Chem 1995; 41: 1129-1134.

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