Blood amylase increased: causes
Amylase is an enzyme synthesized in the pancreas and salivary glands. Its level in the blood increases most often in acute or chronic pancreatitis. However, there may be more rare causes of hyperamylasemia.
What is an amylase blood?
Amylase is the digestive enzyme system secreted by the pancreas and salivary glands. The pancreas is the organ of external and internal secretion, is located behind the stomach. It produces various enzymes that help break down food in the intestine, and hormones (e.g. insulin and glucagon).
Amylase breaks down the carbohydrate starch into small groups and monosaccharides. In healthy people, 40 – 45% of blood amylase produced by the pancreas, and 55 – 60% of salivary glands. In addition, amylase is contained in the fallopian tubes, fluid cysts, testes, lungs, thyroid, tonsils, breast milk, sweat, tears, and some malignant tumors. However, these types of amylase make only a minor contribution to its concentration in the blood.
Sometimes the pancreas can be damaged or inflamed, causing excessive or insufficient production of amylase. Pathological changes the amount of amylase in the blood can be a symptom of disorders in the functioning of the pancreas.
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Who carried out the determination of blood amylase?
The level of amylase is usually determined in the serum. Sometimes it is carried out the detection in the urine samples – this analysis is called diastasis. A blood test for amylase doctors prescribe, as a rule, if you suspect a patient has a disease of the pancreas – pancreatitis, cancer or gallstones. The symptoms of these diseases may be different, but the most common:
- Severe pain in the abdomen.
- Deterioration of appetite.
- The increase in temperature.
- Nausea and vomiting.
How to prepare for testing for amylase?
Before analysis one should not drink alcohol. You should also tell your doctor about all accepted medicines. Certain medicines can change the results of the analysis. The doctor might tell the patient, what tools are need to cancel or adjust their dose. Medicines that can change the level of amylase in the blood:
- Preformed contraceptives.
- Cholinergic means.
- Opiates (Morphine, Omnopon and morphine).
- Thiazide diuretics (gidrokhlorisiazit, Indapamide).
As evidenced elevated levels of amylase?
The increase of amylase in the blood called hyperamylasemia. Most often in the blood may be increased amylase in diseases of the pancreas. Acute or chronic pancreatitis develops when the enzymes that break down food in the gastrointestinal tract, are activated in the pancreatic tissue and destroys it. In this case, the level of amylase in the blood increases.
Also hyperamylasemia may be associated with pseudocysts, trauma to the pancreas and pancreatic ascites. Traumatic injury of the pancreas may be the result of blunt abdominal trauma, operations on the abdominal cavity or retroperitoneal space. Amylase in the blood may increase gallstone disease and chronic cholecystitis. Gallstones can cause blockade of the pancreatic duct.
Hyperamylasemia can also be caused by diseases of the parotid salivary glands. Parotitis usually develops as a result of injury or surgery to the salivary glands, radiation exposure of the neck and of the parotid gland or stones in the salivary duct. Another reason for the defeat of the salivary glands is chronic alcoholism. Sometimes the amylase of the blood increases when liver and kidney failure, which is associated with the deterioration of its elimination from the body.
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Macroamylasemia is a benign condition in which amylase is bound with a large molecule (e.g., immunoglobulin, or a polysaccharide), which reduces its excretion from the body through the kidneys. Approximately 2 – 5% of patients with increased blood amylase can be macroamylasemia.
Also to increase the level of amylase in the blood lead to various intestinal diseases, including inflammatory diseases of the small intestine, mesenteric thrombosis, intestinal obstruction, appendicitis and peritonitis. This is due to its increased absorption from the intestinal lumen. If perforation of the lumen of the digestive tract of its contents falls into the peritoneal cavity, causing inflammation and causing absorption of amylase through the peritoneum, which can cause hyperamylasemia. Sometimes the reason for the increase of amylase in the blood can be an ectopic pregnancy, cysts of the fallopian tubes and ovaries and salpingitis.
Rare causes hyperamylasemia can be malignant tumors of the lung, ovaries, pancreas and colon, pheochromocytoma, thymoma, multiple myeloma and breast cancer. Also, amylase may be elevated in acidosis, systemic lupus erythematosus, pneumonia, traumatic brain injury, burns, abdominal aortic aneurysms, anorexia and bulimia, poisoning by organic phosphates. Sometimes hyperamylasemia observed in severe polytrauma after heart surgery with use of cardiopulmonary bypass.
The normal value of blood amylase
The normal value of blood amylase depends on the laboratory which conducted the analysis, and reagents. In some cases, the norm is the concentration of 23 to 85 U/l, and sometimes 40 – 140 U/L. the Person who completes the analysis of the level of amylase, it is possible to specify the reference standards in the specific laboratory. After receiving the results of the analysis need to consult a doctor who will be able to interpret them.