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Objective. There are no recommendations on how to proceed in patients with increased pancreatic enzyme activities but non-pancreatic diseases. The objective of this study was to investigate prospectively in a general medical hospital the incidence, causes and clinical impact of hyperamylasaemia and/or hyperlipasaemia in these patients. Material and methods. During a 4-month period in 2004, amylase and lipase activities were measured in all patients (n, 1765) admitted to the Department of Internal Medicine of the Municipal Clinic of Luneburg, Germany. Patients with increased enzyme activities underwent abdominal ultrasonography and, if inconclusive, other imaging procedures. Results. Amylase and/or lipase activities were increased in 140 (8%) patients with non-pancreatic diseases: amylase in 29 cases (21%) and 1 case (1%)<3 and>3 times the upper limit of normal, respectively, lipase in 120 cases (86%) and 6 cases (4%)<3 and>3 times, respectively. In 53 (38%) patients no further imaging studies could be performed. In the remaining 87 patients amylase was increased in 18 patients (21%) and lipase in 3 patients (3%). The pancreas was normal on imaging procedures in 77 (89%) patients and abnormal in 10 (11%) (chronic pancreatitis: 4, small cystic lesions: 6). The cystic lesions were mostly located in the pancreas head, probably corresponding to branch-duct intraductal papillary mucinous neoplasm. Conclusions. Increased pancreatic enzyme activities occur in 8% of hospitalized patients with non-pancreatic diseases, but pancreatic abnormalities will be found in only a few (11%), which are unlikely to need further investigation or therapy. Therefore, routine analysis of amylase or lipase activities in patients with non-pancreatic diseases is not indicated. [ABSTRACT FROM AUTHOR]

This study reports a case of a patient with lambda-light chain multiple myeloma who developed a high hyperamylasaemia of the salivary type during the disease and soon afterwards died. Ectopic production of amylase by myeloma cells has been described in a few cases and demonstrated by tissue culture and immunohistochemical techniques. The common characteristics of these cases were: salivary amylase isoenzyme increase, high tumor mass, extensive extra-medullary spread, extensive bone destruction and poor prognosis. In patients with amylase-producing multiple myeloma, the onset of hyperamylasaemia heralds a rapid disease progression; therefore, in these patients, a simple test such as serum amylase may represent a reliable disease activity index and provide an additional prognostic information. [ABSTRACT FROM AUTHOR]