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Hyperamylasemia: Beacon or Siren?

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Department of Medicine, University of California, Irvine, California

Ann Intern Med. 1974;80(5):665. doi:10.7326/0003-4819-80-5-665
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Amylase is a fascinating and challenging enzyme. Arising from sources still not entirely clear, it apparently circulates in the blood only to exit in the urine or to be destroyed in sites not yet fully identified. Though long used as a clinical marker of pancreatic abnormality, the diagnostic value of elevated serum amylase activity is hampered by shortcomings in current knowledge. Not only is the degree of change of serum amylase unpredictable, but its seemingly perverse and capricious behavior often creates a diagnostic dilemma.

Hyperamylasemia is notoriously short-lived in most cases of acute pancreatitis and occurs only infrequently in patients


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