Pathology Handbook

Amylase

Clinical Indications

The enzyme amylase is present in pancreas and salivary glands and its measurement is invaluable in management of acute abdomen. Clearly elevated levels (>900 IU/L) are virtually diagnostic of acute pancreatitis.

Amylase is of no value in diagnosis of either chronic pancreatitis, insufficiency of the pancreas or pancreatic cancer since serum levels are usually normal.

Amylase is cleared by renal excretion and persistent elevated levels may be seen in macroamylasaemia, a rare and benign condition, due to complexing of amylase with immunoglobulin

Request Form 

Request on ICE

Availability

On request. May be requested urgently.

Turnaround Time

Same day

Specimen

Serum in gold-top vacutainer

Volume

2 ml

Container

Vacutainer gold top

Lab Handling

Aliquot and store at 4C

Causes for Rejection

Unlabelled or incorrectly labelled sample; not meeting specific criteria for analysis

Reference Range

Amylase reference range <100 IU/l. Levels up to 180 IU/l may be seen in Asians, West Indians and Chinese.

Interpretation

A marked rise in serum amylase occurs in 95% of patients with acute pancreatitis within 2-12 hours of onset. The highest serum activity is present 12-72 hours after the onset and usually returns to normal in 4-8 days. Acute non-pancreatic conditions, which may also elevate amylase levels, include acute parotitis, peritonitis, small intestine obstruction, perforated peptic ulcer, rupture of a tubal pregnancy, contraction of the sphincter of Oddi following morphine administration, and mesenteric thrombosis.