Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Amylase isoenzyme analysis of serum and urine has been performed in 4001 normal persons and 500 patients with various disease using electrophoresis on thin layer polyacrylamide gel. Although elevation of amylase activity in amylase-1 and 2 has been reported to be the specific findings in patients with pancreatitis, 1.69% of normal persons had an elevated Amylase-2(named "Dominant Amylase-2") up to the same levels as major isoenzymes (Amylase-1 and 3), along with Amylase-1. Pedigree study confirmed an autosomal dominant mode of inheritance for Dominant Amylase-2. Knowledge of the genetic polymorphism is of importance in clinical assessment of amylase isoenzymes in patients having an elevated Amylase-2 suggestive of pancreatitis. Predominance of the pancreatic components in serum and urine has been revealed to be a specific index of pancreatic involvement. However, the existecne of an inherited trait of pancreatitis-like isoamylase pattern in healthy individuals must be borne in mind. On the basis of the present study, it may be concluded that a rise in the pancreatic type isoenzymes may not necessarily indicate underlying pancreatitis, especially in the absence of elevated amylase and lipase levels.
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PMID:Clinical evaluation of the pancreatitis-like isoamylase pattern in normal persons. 15 Sep 92

Isoamylase determinations and measurements of the ratio of the renal clearance of amylase relative to creatinine (CAm/CCr) were employed in an attempt to improve the diagnostic accuracy of the standard amylase measurement. An elevated CAm/CCr reflects defective proximal tubular reabsorption of amylase which occurs in virtually all patients with clear-cut acute pancreatitis. However, other conditions that apparently are associated with acute defective tubular function, such as burns and diabetic acidosis, may cause an elevated ratio. Thus, elevations of CAm/CCr cannot be considered to be specific for acute pancreatitis. Pancreatic isoamylase represents, on the average, about 33% of the normal serum amylase activity, whereas about 66% is salivary-type isoamylase. Isoamylase measurements are useful in determining whether an elevated value for serum amylase activity is of pancreatic origin. However, this measurement is not useful for determining whether patients with normal serum amylase activity have pancreatitis.
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PMID:Clinical use of amylase clearance and isoamylase measurements. 44 15

On the assumption that a rise in the pancreatic type isoamylases may not necessarily indicate underlying pancreatitis, genetic studies of human serum and urinary amylase isoenzymes have been performed with the use of electrophoresis. Although the preponderant increase in the two principal pancreatic isoamylases Amylase-1 and 2 has been accepted to be a specific index of pancreatic involvement, 1.68% of normal persons had Amylase-2 with an elevated amylase activity (named "Dominant Amylase-2") up to the same levels as the major isoenzymes. Results of pancreozymin-secretin test and other laboratory findings of these persons with Dominant Amylase-2 were all within normal ranges. Pedigree studies confirmed an autosomal dominant mode of inheritance for this variant. The important of serial determination and pedigree investigations has been shown to distinguish normal persons having Dominant Amylase-2 from patients with pancreatitis without elevated amylase activity. The existence of an inherited trait of pancreatitis-like isoamylase pattern in healthy individuals must be born in mind before coming to a conclusion when amylase isoenzymes are used for clinical medicine, though preponderance of the pancreatic type isoenzymes in serum and urine has been revealed to be a characteristic finding in pancreatitis. Knowledge of amylase genetic polymorphism provides a scientific basis for amylase isoenzyme interpretation.
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PMID:Pancreatitis-like isoamylase pattern in normal persons. 70 65

This investigation was designed to determine whether serum isoamylase measurements can aid in establishing the diagnosis of acute pancreatitis in renal failure patients. Twenty-two hemodialysis patients were studied, four of whom had documented acute pancreatitis. Total serum amylase and pancreatic isoamylase concentrations were significantly higher (p less than 0.02) in the pancreatitis patients than in the 18 patients without pancreatitis, but there was appreciable overlap between these two groups. In each of the four patients with pancreatitis, the percentage of serum amylase derived from the pancreas (range, 80% to 90%) was well above the highest value (67%) observed in the patients without pancreatitis. These results suggest that determination of the percentage of serum amylase represented by pancreatic isoamylase is of assistance in establishing the diagnosis of acute pancreatitis in renal failure patients.
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PMID:Serum isoamylase measurements in pancreatitis complicating chronic renal failure. 75 28

This review of the English literature on amylase was undertaken because no recent discussion of the subject could be located, no comprehensive list of disorders causing hyperamylasemia or hyperamylasuria is available, and several major advances in the area have been made, notably the amylase isoenzyme determination and Cam/Ccr ratio. Several important concepts have emerged from this review. First, hyperamylasemia and hyperamylasuria are not specific indices of the presence of pancreatic disease or damage. Second, serum and urinary amylase levels can be spuriously normal with hypertriglyceridemia and pancreatitis. Third, the current emphasis on diagnostic methods for measuring serum amylase isoenzymes promises to improve the specificity of this determination. It will also enhance our understanding of the sources, distribution, metabolism, and elmination of amylase. Fourth, the development of the Cam/Ccr ratio may provide a practical diagnostic tool for separating clinically significant hyperamylasemia due to pancreatitis from that caused by other factors. Both the the isoamylase determination and Cam/Ccr ratio clearly require future research to place their clinical application in the proper perspective.
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PMID:Amylase--its clinical significance: a review of the literature. 78 63

Pancreatic isoamylases were determined in serum and in duodenal aspirate in 7 patients with pancreatitis. The serum activities were abnormally low in 3 cases with cancer and in 7 cases with pancreatitis. In 2 cases with normal pancreatic isoamylase activities in serum, pancreatic disease was reflected by an abnormal isoamylast pattern. Thus the serum amylast determination was abnormal in 12 of the 20 patients.
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PMID:Isoamylases in pancreatic carcinoma and chronic relapsing pancreatitis. 83 69

We investigated three possible causes of the increased ratio of amylase/creatinine clearance observed in acute pancreatitis. The presence of rapidly cleared isoamylase was excluded by studies of serum and urine, which demonstrated no anomalous isoamylases. In pancreatitis, the ratios (+/-1 S.E.M.) of both pancreatic isoamylase (9.2+/-0.6 per cent) and salivary isoamylase (8.6+/-1.6 per cent) were significantly (P less than 0.01) elevated over respective control values (2.4+/-0.2 and 1.8+/-0.2 per cent). Increased glomerular permeability to amylase was excluded by the demonstration of normal renal clearance of dextrans. We tested tubular reabsorption of protein by measuring the renal clearance of beta2-microglobulin, which is relatively freely filtered at the glomerulus and then avidly reabsorbed by the normal tubule. During acute pancreatitis the ratio of the renal clearance of beta2-microglobulin to that of creatinine was 1.22+/-0.52 per cent, an 80-fold increase over normal (0.015+/-0.002 per cent), with a rapid return toward normal during convalescence. Presumably, this reversible renal tubular defect also reduces amylase reabsorption and accounts for the elevated renal clearance of amylase/creatinine observed in acute pancreatitis.
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PMID:Mechanism of increased renal clearnace of amylase/creatinine in acute pancreatitis. 98 35

The diagnostic usefulness of serum amylase isozyme measurement was investigated in 17 cases of definite chronic pancreatitis and 13 cases of suspected chronic pancreatitis, a total of 30 cases. Six types of serum isoamylase patterns were distinguished according to the character of the two main amylase activities at the fraction of fast-gamma globulin and pre-gamma globulin. The amylase activity of the fast-gamma fraction rises in acute exacerbation, and falls in cases of chronic calcifying pancreatitis and in cases with a marked decrease in pancreatic exocrine function. Especially, a fall in fast-gamma amylase activity excellently reflects a decrease in pancreatic enzyme production. The measurement of amylase activity at the fast-gamma fraction therefore appears to be a useful method for assessing pancreatic damage. The significance of a frequent rise in pre-gamma amylase activity in chronic pancreatitis remains unknown.
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PMID:Serum amylase isozyme changes in chronic pancreatitis and their clinical significance. 99 54

Isoamylase analysis of the serum and urine of a patient with anaplastic spindel cell carcinoma of the pancreas revealed that virtually all of the serum amylase and almost all of the urine amylase behaved chromatographically as the salivary (S) type. Both the serum and urine amylases were bound by a substance derived from a macroamylase complex which had been shown to bind only salivary amylase and to lack any affinity for pancreatitis (P) type amylase. The ratio of amylase to creatinine clearance was markedly increased (12.5%) without evidence of acute pancreatitis at autopsy and despite the presence of only a minute amount of P-type isoamylase in the serum.
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PMID:Nonpancreatic-type hyperamylasemia associated with pancreatic cancer. 127 25

This study was undertaken to investigate the incidence of postoperative hyperamylasemia and amylase levels of intraperitoneal drainage in 106 patients undergoing major abdominal surgery. The results were as follows: 1. Postoperative hyperamylasemia was found in 36.8% of all patients, with higher incidence of hyperamylasemia being in accordance with greater surgical intervention to the pancreas. 2. The isoamylase pattern of postoperative hyperamylasemia was dominant in the salivary type. 3. The levels of such serum pancreatic enzymes as lipase, trypsin and elastase 1 were higher in the pancreatic-type group than in the salivary-type group, particularly with the elastase 1 levels being statistically higher in the former. 4. Increases in peritoneal amylase activity were found in those cases of greater surgical intervention to the pancreas, postoperative hyperamylasemia and higher serum pancreatic isoamylase levels. 5. Diagnosis of postoperative pancreatitis was confirmed in one case by clinical and laboratory findings and CT examination. It might be concluded that postoperative high peritoneal amylase levels suggest occurrence or possible occurrence of postoperative pancreatitis.
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PMID:[Postoperative hyperamylasemia in patients undergoing abdominal surgery: the relationship between serum and peritoneal amylase levels]. 127 73


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