Acute pancreatitis (amylase)

Total amylase levels, clinically measured rather than P-amylase due to rapidity of assay, rise within 2-12 hours of onset of abdominal pain during acute pancreatitis. Levels are usually reasonably diagnostic when greater than 4 times the normal value; above this level, the concentration of plasma amylase does not seem to exhibit a direct relationship with severity of pancreatitis. Overall specificity for acute pancreatitis is only 70% due to hyperamylasaemia being caused by a range of abdominal conditions.

Amylase levels peak after 1-3 days. Usually, they return to normal by day 5. Elevations of levels beyond this indicate increased likelihood of complications e.g. pseudocyst formation.

Reference

1. Rompianesi G, Hann A, Komolafe O, et al. Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis. Cochrane Database Syst Rev. 2017 Apr 21;(4):CD012010.