Reading from a Pharmacia Diagnostics booklet "Isoamylase in clinical
practice" written by Gunnar Skude and published way back in 1980:-
"In ovarian carcinoma an increased amount of the salivary group of
isoamylases can be seen in some cases or there may be an increased amount of
the faster migrating female genital tract isoamylases. In most of these
cases, the contribution from the genital tract is so small that serum
isoamylase determination is not informative. As a rule the serum isoamylase
pattern does not become significantly abnormal until the disease is in an
advanced stage."
The references are given as:-
a) Sandiford JA & Chiknas SG, Hyperamylasaemia and ovarian carcinoma. Clin
Chem 25: 948-950, 1979.
b) Unpublished observations of Skude G and co-workers.
c) Warshaw AL & Lee K-H: Characteristics of serum isoenzymes of amylase in
diseases of the liver, pancreas, salivary gland, lung and genitalia. J Surg
Res 22; 362-369, 1977.
d) Merritt AD & Karn RC; The human alpha-amylases. In Advances in human
genetics, Plenum Press, New York - London, 1977, 135.
And also:-
"In bronchogenic carcinoma about a dozen cases have been reported possessing
hyperamylasaemia due to increased activity of salivary isoamylases. in
addition to salivary isoamylases also unusual isoamylases have been noted in
some cases. The tumours have been either adenocarcinoma or oat cell
carcinoma. Until now no systematic studies concerning the frequency of
abnormal isoamylase patterns in brochogenic carcinoma have been published
but according to preliminary data the frequency seems to be low."
References:-
e) Amman RW et al: Hyperamylasaemia with carcinoma of the lung. Ann Internal
Med 78: 521-525, 1973.
f) Sudo K & Kanno T: Properties of the amylase produced in carcinoma of the
lung. Clin Chim Acta 73: 1-12, 1976.
g) Flood et al; Marked hyperamylasaemia associated with carcinoma of the
lung. Clin Chem 24: 1207-1212, 1978.
h) As per (b) above.
Anecdotally, many years ago we did find one oat cell carcinoma as a result
of the investigation of a chance finding of hyperamylasaemia.
Ken Robertson
Senior Scientist I/C (External Research)
Royal Perth Hospital, Western Australia.
Disclaimer: Views expressed are entirely personal and do not necessarily
reflect those of my employer.
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-----Original Message-----
From: JOE BEGLEY [mailto:[log in to unmask]]
Sent: Saturday, 28 July 2001 04:14
To: [log in to unmask]
Subject: Source of raised Amylase?
Can anyone help? We had a 70 year old lady, known myeloma with
hypercalcaemia admitted with abdominal pain, suspected pancreatitis. Amylase
4,500 (url < 100). 6/12 later clinically well, amylase (measured on a number
of occasions over the months) remains c 5,000. Abdo U/S and CT show no cysts
/ deposits in pancreas. Has high urine amylase output so not
macroamylasaemia. Amylase is non-pancreatic (as per pancreatic lab in MRI) -
they measure the pancreatic isoenzyme so by inference the source is
salivary. However, there is no evidence of salivary gland disease.
I vaguely recall a case report some years ago where a non-pancreatic,
non-salivary amylase elevation was found in a patient with, I think, some
form of malignancy but can't trace it. Any comment / suggestion welcome.
Thanks
Joe Begley
Poole Hospital
(on the sub-tropical South Coast!)
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