[Extrapancreatic hyperamylasemia. Diagnostic value of isoamylase and lipase determination]

The P- and S-isoamylase and lipase of 72 patients with extrapancreatic hyperamylasemia were determined and their diagnostic value checked to rule out a pancreatic origin. The hyperenzymemia was generally slight although extremely high values were observed in isolated cases. The increased serum amylase results were more often caused by P-, rather than S-isoamylase, while in 28% of cases lipase was also increased. In lung diseases, anorexia and disorders of the head organs only S-isoamylase was pathologically increased while P-isoamylase and lipase remained normal. In other entities such as liver, stomach and intestinal diseases, functional disorders, acidosis, infections, etc., the isoenzymes and lipase showed a variable tendency to increase. Thus, extrapancreatic hyperamylasemia could not always be identified by detection of isoamylases or with the aid of lipase determinations. Overall, however, lipase more often remained in the normal range and was therefore more useful than determination of the isoamylases in differentiating hyperenzymemia.