Amylase is often requested in a patient population with a low pre-test probability of acute pancreatitis in the setting of nonspecific symptoms. Hyperamylasemia that persists for weeks or months without apparent cause is often challenging and not uncommon in clinical practice. Chronic asymptomatic hyperamylasemia, based on ethnic and age appropriate reference range, can be further classified into nonpancreatic hyperamylasemia and pancreatic hyperamylasemia that is usually associated with elevated lipase activity. The aim of this article was to outline the aetiology of chronic hyperamylasemia to help clinicians choose appropriate further investigations and reach a prompt diagnosis. We also propose a diagnostic algorithm for patients with chronic hyperamylasemia.
Ingrid Borovickova, Nikita R Bhatt, Gerard P Boran, Paul F Ridgway
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