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 specifity 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.
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