[Hyperamylasemia in acute exacerbation in patients with chronic respiratory failure]

Serum amylase level was examined in 129 cases (225 episodes) of chronic respiratory failure at acute exacerbation, and in 59 cases (62 episodes) of pneumonia without respiratory failure as a control. Cases accompanying diseases, such as acute pancreatitis, parotiditis, ileus, and renal dysfunction, which were expected to develop hyperamylasemia were excluded. The 225 episodes were divided according to the cause of acute exacerbation into 4 groups: pneumonia, bronchitis, right heart failure without infection, and others (e.g. hemoptysis). Hyperamylasemia (greater than 400 S-U) was observed in groups of pneumonia (15/40 = 35.5%) and of bronchitis (12/95 = 12.6%) respectively, but not in those of right heart failure without infection (0/73 = 0%) and others (0/17 = 0%). As a result, hyperamylasemia was found only under conditions of inflammation of lung parenchyma and bronchi with acute exacerbation of respiratory failure. On the other hand no hyperamylasemia was observed in 62 episodes of only pneumonia without respiratory failure. It was concluded that both respiratory tract infection and acute respiratory failure are necessary factors for development of hyperamylasemia originating from lung or bronchi.