Dear Collective

 

We have a 66y F who presented in May last year with right upper quad abdo pain and general abdo discomfort with an amylase of 171 u/l NR (28-100)

LFT’s , U+E, CRP Lipids all normal.

 

Her abdo symptoms disappeared (no other investigations performed, never ultrasound scanned)

 

Her amylase persists to be raised to this day (168,158,264,215,198,2110)

 

We did a macroamylase check using standard protocol below

The formula is (urine amylase x serum creatinine) / (serum amylase x urine creatinine) x 100.
The normal range is 2-5%. In Macroamylasemia the ratio is usually less than 2%

 

She gave a value of 1.6% so we thought we had nailed it, but………………..

 

Her Lipase has come back at 75 u/l top of the range being 70 .

 

The only other slightly unusual feature is a persistently low alkaline  phosphatase which runs 40 -45 u/l

 

Any thoughts

 

Cheers John