Clinical application of organ specific isoamylases

Since hyperamylasemia with or without abdominal pain is a frequently encountered problem, serum isoamylase analysis in 52 patients was done to see if the organ source of the amylase would be helpful in a clinical setting. Four patterns of hyperamylasemia were found: 1) AMY1 (salivary) hyperamylasemia; 2) AMY2 (pancreatic) hyperamylasemia; 3) Both AMY1 and AMY2 amylase elevated; and 4) macroamylasemia. A variety of conditions other than pancreatitis were associated with hyperamylasemia, and some patients who were thought on clinical grounds to have pancreatitis had raised levels of AMY1 (salivary) amylase. This study suggests that hyperamylasemia alone is a poor indicator of pancreatic disease, and that isoamylase analysis will improve the accuracy with which amylase determinations are used.