Examinations
Examinations
Amylase is a digestive enzyme responsible for breaking down carbohydrates.
The highest concentrations of amylase are found in the saliva and pancreas.
Amylase produced in the pancreas—referred to as pancreatic amylase (P-type)—is part of pancreatic juice. Pancreatic juice containing lipase is secreted through the pancreatic duct into the duodenum, aiding in digestion.
Salivary amylase—referred to as salivary amylase (S-type)—breaks down dietary starch in the mouth.
Under normal circumstances, small amounts of amylase circulate in the blood. About 60% of this is salivary amylase (S-type), while the remaining 40% is pancreatic amylase (P-type).
When the pancreas is damaged or its duct becomes obstructed by stones or tumors, as in the case of pancreatitis, pancreatic amylase (P-type) is released into the bloodstream in significant quantities. However, the activity of salivary amylase does not increase.
Small amounts of amylase are also produced by the ovaries, intestines, and skeletal muscles.
- The test requires a blood sample drawn from a vein.
- Fasting for 12 hours before the test is required (water is allowed).
- An increase in pancreatic amylase activity in the blood without a change in salivary amylase activity confirms pancreatic pathology. For instance, in acute pancreatitis, pancreatic amylase activity can account for up to 90% of the total amylase activity.
- Diagnosing pancreatitis when total amylase activity is elevated postoperatively.
- Suspected pathology of the salivary glands, ovaries, or bronchi.
- Confirming acute or chronic pancreatitis.
- Suspected diseases of the salivary glands or ovaries.
- Acute pancreatitis: The activity of pancreatic amylase can significantly exceed normal levels, comprising a high percentage of total amylase activity. However, in some patients with acute pancreatitis, amylase levels may be only slightly elevated or even normal. Amylase activity does not always correlate with the severity of pancreatic damage.
- Chronic pancreatitis: Initially, amylase activity moderately increases but then decreases and may return to normal as pancreatic damage worsens.
- Diabetic ketoacidosis: A complication of diabetes linked to both high blood sugar levels and visible pathological processes in the pancreas.
- Pancreatic trauma.
- Pancreatic cancer.
- Obstruction of the pancreatic duct (e.g., due to stones).
- Acute appendicitis or peritonitis.
- Perforated gastric ulcer.
- Acute cholecystitis (inflammation of the gallbladder).
- Intestinal obstruction.
- Aortic aneurysm rupture.
- Macroamylasemia: A condition where amylase binds to large serum proteins, preventing its filtration by the kidneys, leading to its accumulation in the blood.
Causes of Decreased Pancreatic Amylase Levels
- Reduced pancreatic function.
- Cystic fibrosis: A severe hereditary condition affecting the exocrine glands (lungs and gastrointestinal tract).
- Pancreatectomy (surgical removal of the pancreas).