 |
|
Gastroenteritis-Associated Hyperamylasemia
Prevalence and Clinical Significance
Shomron Ben-Horin, MD;
Zvi Farfel, MD;
Meir Mouallem, MD
Arch Intern Med. 2002;162:689-692.
Background Serum amylase levels can be elevated in various pathological conditions.
However, acute gastroenteritis has not been widely recognized as a cause for
hyperamylasemia.
Patients and Methods We conducted a retrospective study of amylase results for all patients
hospitalized or discharged from the emergency department with a diagnosis
of gastroenteritis from April through November 1999. Patients with other possible
medical causes for elevated amylase levels were excluded. We also compared
the clinical and laboratory parameters of hyperamylasemic vs normoamylasemic
hospitalized patients with gastroenteritis.
Results A total of 1041 patients with acute gastroenteritis were identified.
Serum amylase levels were determined in 701 patients and were abnormally elevated
in 66 of them. In 15 patients, other possible causes of hyperamylasemia were
present, and these patients were excluded. The mean serum amylase level among
the remaining 51 patients (7.4% of the remaining 686 patients with gastroenteritis)
was 1.32 of the upper normal level, with a range of up to 2.2 times the upper
normal range. Clinicians tended to admit more hyperamylasemic patients than
normoamylasemic patients (10 of 51 vs 65 of 635; P
= .03, 1 sided). However, the course of gastroenteritis in the hospitalized
hyperamylasemic patients did not differ significantly from that in the hospitalized
normoamylasemic patients, as judged by the clinical signs and symptoms, laboratory
results, length of hospital stay, and need for antibiotics.
Conclusions Gastroenteritis is associated with a mild to moderate elevation of serum
amylase levels in a significant portion of patients and should be included
in the differential diagnosis of hyperamylasemia. Such elevation, however,
does not seem to bear clinical significance in terms of the severity of disease.
From the Departments of Medicine F (Dr Ben-Horin) and E (Drs Farfel
and Mouallem), Sheba Medical Center, Tel Hashomer, Israel, and Sackler School
of Medicine, Tel-Aviv University, Tel Aviv, Israel.
RELATED ARTICLE
Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2002;162(6):722-723.
FULL TEXT
|
