The asymptomatic pancreatic hyper-fermentation


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Abstract

The asymptomatic increase of level of enzymes of pancreas often results in such incorrect diagnosis as chronic pancreatitis and in prescription of unnecessary treatment. Meanwhile, in many similar cases hyperenzymemia has a benevolent nature. The article discusses possible causes of pancreatic hyperenzymemia in healthy persons. The algorithm of diagnostic search in this clinical situation is proposed.

About the authors

Aleksandr L. Krasnovskiy

The N.I. Pirogov Russian national research medical university Minzdrav of Russia

Email: alexkras758@yandex.ru
MD, PhD, assistant of department of internal diseases of medicobiologic faculty 117997 Moscow, Russia

S. P Grigoriyev

The N.I. Pirogov Russian national research medical university Minzdrav of Russia

д.м.н., профессор, заведующий кафедрой внутренних болезней медико-биологического факультета 117997 Moscow, Russia

I. V Zolkina

The N.I. Pirogov Russian national research medical university Minzdrav of Russia

к.м.н., доцент кафедры внутренних болезней медико-биологического факультета 117997 Moscow, Russia

E. O Loshkareva

The N.I. Pirogov Russian national research medical university Minzdrav of Russia

к.м.н., доцент кафедры внутренних болезней медико-биологического факультета 117997 Moscow, Russia

L. A Brutskaya

The central clinical hospital of the Russian academy of sciences

зав. 3-м терапевтическим отделением 117593 Moscow, Russia

E. A Bykova

The N.I. Pirogov Russian national research medical university Minzdrav of Russia

ординатор кафедры внутренних болезней медико-биологического факультета 117997 Moscow, Russia

References

  1. Siegenthaler W., ed. Differential Diagnosis in Internal Medicine: From Symptom to Diagnosis. 1st English Ed. Stuttgart; New York: Thieme; 2007.
  2. Frulloni L., Patrizi F., Bernardoni L., Cavallini G. Pancreatic hyperenzymemia: clinical significance and diagnostic approach. JOP. 2005; 6(6): 536-51.
  3. Warshaw A.L., Lee K.H. Macroamylasemia and other chronic nonspecific hyperamylasemias: chemical oddities or clinical entities? Am. J. Surg. 1978; 135(4): 488-93.
  4. Warshaw A.L., Hawboldt M.M. Puzzling persistent hyperamylasemia, probably neither pancreatic nor pathologic. Am. J. Surg. 1988; 155(3): 453-6.
  5. Gullo L. Chronic nonpathologicalhyperamylasemia of pancreatic origin. Gastroenterology. 1996; 110(6): 1905-8.
  6. Gullo L. Benign pancreatic hyperenzymemia. Dig. Liver Dis. 2007; 39(7): 698-702.
  7. Gullo L., Ventrucci M., Barakat B., Migliori M., Tomassetti P., Pezzilli R. Effect of secretin on serum pancreatic enzymes and on the Wirsung duct in chronic nonpathological pancreatic hyperenzymemia. Pancreatology. 2003; 3(3): 191-4.
  8. Gullo L. Familial pancreatic hyperenzymemia. Pancreas. 2000; 20(2): 158-60.
  9. Gullo L., Migliori M. Benign pancreatic hyperenzymemia in children. Eur. J. Pediatr. 2007; 166(2): 125-9.
  10. Tsianos E.B., Jalali M.T., Gowenlock A.H., Braganza J.M. Ethnic 'hyperamylasaemia': clarification by isoamylase analysis. Clin. Chim. Acta. 1982; 124(1): 13-21.
  11. Gullo L. Day-to-day variations of serum pancreatic enzymes in benign pancreatic hyperenzymemia. Clin. Gastroenterol. Hepatol. 2007; 5(1): 70-4.
  12. Galassi E., Birtolo C., Migliori M., Bastagli L. et al. A 5-year experience of benign pancreatic hyperenzymemia. Pancreas. 2014 Apr 16. [Epub ahead of print].
  13. Pezzilli R., Morselli-Labate A.M., Casadei R., Campana D. et al. Chronic asymptomatic pancreatic hyperenzymemia is a benign condition in only half of the cases: a prospective study. Scand. J. Gastroenterol. 2009; 44(7): 888-93.
  14. Amodio A., Manfredi R., Katsotourchi A.M., Gabbrielli A. et al. Prospective evaluation of subjects with chronic asymptomatic pancreatic hyperenzymemia. Am. J. Gastroenterol. 2012; 107(7): 1089-95.
  15. Testoni P.A., Mariani A., Curioni S., Giussani A. et al. Pancreatic ductal abnormalities documented by secretin-enhanced MRCP in asymptomatic subjects with chronic pancreatic hyperenzymemia. Am. J. Gastroenterol. 2009; 104(7): 1780-6.
  16. Donati F., Boraschi P., Gigoni R., Salemi S. et al. Secretin-stimulated MR cholangio-pancreatography in the evaluation of asymptomatic patients with non-specific pancreatic hyperenzymemia. Eur. J. Radiol. 2010; 75(2): e38-44.
  17. Gallucci F., Buono R., Ferrara L., Madrid E. et al. Chronic asymptomatic hyperamylasemia unrelated to pancreatic diseases. Adv. Med. Sci. 2010; 55(2): 143-5.
  18. Bode C., Riederer J., Brauner B., Bode J. C. Macrolipasemia: a rare cause of persistently elevated serum lipase. Am. J. Gastroenterol. 1990; 85(4): 412-6.
  19. Oita T., Yamashiro A., Mizutani F., Tamura A. et al. Simultaneous presence of macroamylase and macrolipase in a patient with celiac disease. RinshoByori. 2003; 51(10): 974-7.
  20. Wilding P., Cooke W.T., Nicholson G.I. Globulin-bound amylase: a cause of persistently elevated levels in serum. Ann. Intern. Med. 1964; 60(6): 1053-9.
  21. Berk J.E., Kizu H., Wilding P., Searcy R.L. Macroamylasemia: a newly recognized cause for elevated serum amylase activity. N. Engl. J. Med. 1967; 277(18): 941-6.
  22. Губергриц Н.Б., Лукашевич Г.М., Загореко Ю.А. Макроамилаземия - безобидное заблуждение или опасное незнание? Сучасна гастроентерологiа. 2006; 32(6): 93-9.
  23. Абдулганиева Д.И., Одинцова А.Х., Черемина Н.А., Хафизова А.Х. и др. Всегда ли гиперамилаземия связана с хроническим панкреатитом? Практическая медицина. 2011; 55(7): 157-9.
  24. Crook M.A. Hyperamylasaemia: don’tforgetundiagnosedcarcino ma. Ann. Clin. Biochem. Published online before print November 5, 2013, doi: 10.1177/0004563213510490
  25. Mariani A. Chronic asymptomatic pancreatic hyperenzymemia: is it a benign anomaly or a disease? JOP. 2010; 11(2): 95-8.

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