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Answered 2008-02-25 02:15:58

Hyperamylasemia (High Blood Amylase Level) What is hyperamylasemia? Hyperamylasemia may be described as an excess of the pancreatic enzyme - amylase in the blood. Digestion of your dietary intake of carbohydrates and fat relies on the action of amylase, found in the saliva, to begin the digestion of starches. At the same time, lipase from your gastric secretions breaks down the fat in your food. Blood amylase and lipase levels are most frequently drawn to diagnose pancreatitis. When the pancreas is inflamed, increased blood levels of amylase and lipase, pancreatic enzymes, will result. The normal level for amylase is 0-137 U/L. Normal values may vary from laboratory to laboratory. There are many causes of hyperamylasemia. Some may include: Pancreatitis - also known as inflammation of the pancreas. This can cause amylase and lipase levels to be increased up to 3 times the normal limit. Both values should be increased, in order to carry the diagnosis of pancreatitis. Tumors - Amylase enzyme levels may be increased in some pancreas, salivary, prostate, lung and ovarian tumors. Gall bladder infection - Inflammation of the gall bladder (cholecystitis), may cause increased amylase levels, causing hyperamylasemia. Kidney failure can result in hyperamylasemia. Recent Endoscopic Retrograde Cholangio-Pancreatography (ERCP) procedure can result in hyperamylasemia. Medications - some medications may lead to pancreatitis, which could cause hyperamylasemia and hyperlipasemia. Your doctor or healthcare provider will diagnose hyperamylasemia or hyperlipasemia by drawing a tube of blood. If there is a suspicion of gall bladder, pancreas or kidney problems, an ultrasound of the gall bladder or pancreas, or a CAT scan of your abdomen, may also be performed. You may be at risk for pancreatitis, including hyperamylasemia and hyperlipasemia, if you are: Extremely overweight (obese) Have high triglyceride levels in your blood Drink too much alcohol Have been diagnosed with gall bladder stones (which may block the flow of secretions from the pancreas to the intestines) Or have a family history of pancreatitis. What are some symptoms of hyperamylasemia to look for? There are oftentimes no symptoms of hyperamylasemia, unless you develop pancreatitis or some other condition that may cause you to have pain, nausea or vomiting. If your pancreas is inflamed due to pancreatitis, and your pancreas unable to produce insulin, you may have symptoms of Diabetes. These include excessive thirst, frequent urination, extreme tiredness (fatigue), and weight loss. This is often temporary. Symptoms of pancreatitis may include nausea, sweating and weakness. You may also notice pain in the middle of your chest, which may move or radiate to your back. Things you can do to avoid/mitigate hyperamylasemia: Avoiding alcohol, and taking all the prescribed medications are the primary treatments for high blood amylase levels, if you are being followed in the outpatient department, and you have not been diagnosed with any kind of pancreatitis. Follow all of your healthcare provider's instructions. If you are diagnosed with pancreatitis, your healthcare provider may admit you to the hospital. There, they will give you lots of fluids in your vein (IV), provide medication to control your pain, and give you medication to control you nausea and vomiting. You may not be able to eat at first, to give your stomach a rest, but then you will be ordered a diet of foods that can be easily digested. Avoid alcohol. Alcohol use will irritate your pancreas and liver, and may cause interactions with medications. Follow a diet that is low in fat, low in red meat, and high in fiber. Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies). These can cause interactions with other medications. Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or Heart disease. Keep yourself well hydrated. Drink two to three quarts of fluid every 24 hours, unless you are instructed otherwise. If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems. Keep all your appointments. Drugs that may be prescribed by your doctor to treat hyperamylasemia: If you are experiencing high blood amylase levels, and are without symptoms, you doctor or healthcare provider may tell you to avoid alcohol and narcotics, and they may closely monitor your laboratory values and symptoms. Medications used to aid in digestion include: Non-steroidal anti-inflammatory (NSAID) agents and Tylenol® - such as naproxen sodium and ibuprofen may provide relief of pain related to your inflamed pancreas. If you are to avoid NSAID drugs, because of your type of cancer or chemotherapy you are receiving, acetaminophen (Tylenol®) up to 4000 mg per day (two extra-strength tablets every 6 hours) may help. It is important not to exceed the recommended daily dose of Tylenol®, as it may cause liver damage. Discuss this with your healthcare provider. Pancreatic enzymes - Your pancreas may not be able to produce enzymes necessary for fat digestion. This may be due to surgery, cancers, or pancreatitis. Enzymes are available in a pill form, such as pancrease. Taken with meals, this will help you to digest fats. Side effects, such as diarrhea, nausea or stomach pain should be reported to your healthcare provider. When to call your doctor or health care provider: Nausea that interferes with your ability to eat, and is unrelieved by prescribed medication. Diarrhea (4-6 episodes in a 24-hour period), unrelieved with taking anti-diarrhea medication and diet modification. Abdominal pain, sweating, or fever (may be pancreatitis) Any new rashes - if on new medications Any unusual condition or problem that is concerning to you. Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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DefinitionMacroamylasemia is the presence of an abnormal substance called macroamylase in the blood.Causes, incidence, and risk factorsMacroamylase is a substance that consists of an enzyme, called amylase, attached to a protein. Because it is large, macroamylase is filtered very slowly from the blood by the kidneys.Most people with macroamylasemia have no serious underlying disorder, but the condition has been associated with:Celiac diseaseLymphomaHIV infectionMonoclonal gammopathyRheumatoid arthritisUlcerative colitisSymptomsMacroamylasemia does not cause symptoms.Signs and testsA blood test will show high levels of amylase. However, macroamylasemia can be confused with acute pancreatitis, which also causes high levels of amylase in the blood.Macroamylasemia can be diagnosed by measuring amylase levels in the urine. Urine levels of amylase are low. (Urine amylase levels are high in patients with acute pancreatitis.)ReferencesOwyang C. Pancreatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 147.

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