Serum amylase, isoamylase and lipase in acute alcoholism

Hyperamylasemia is found in asymptomatic alcoholics. The aim of this study was to document the incidence of elevations of serum amylase and lipase in asymptomatic alcoholics and to evaluate the contribution of salivary isoamylase to the total serum amylase. One hundred and three patients with acute alcohol withdrawal were studied. Total serum amylase was elevated in 7 patients (6.8%) of whom 4 (57%) showed elevation of salivary isoamylase. Elevated lipase levels were found in 11 patients (10.7%) but correlation of lipase levels with either amylase or isoamylase levels was poor. Thus there was a low but significant incidence of hyperamylasemia which resulted from an elevated salivary isoamylase in the majority of cases. Lipase determination did not assist in defining the origin of the hyperamylasemia and correlated poorly with the other enzymes. It is probably more sensitive than amylase in reflecting the toxic effects of alcohol on the pancreas.