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April 1957

Comparative Value of Serum and Urinary Amylase in The Diagnosis of Acute Pancreatitis

Author Affiliations


Departments of Medicine (Drs. Hinkley and Zieve) and Surgery (Dr. Saxon) and the Radioisotope Service (Mr. Vogel and Dr. Zieve), Veterans Administration Hospital and University of Minnesota. Present address of Dr. Hinkley: 304 Main St., Hayward, Calif.

AMA Arch Intern Med. 1957;99(4):607-621. doi:10.1001/archinte.1957.00260040107011

The very great importance of a rise in serum amylase concentration for verifying a suspicion of pancreatitis is generally recognized, as is the difficulty that would be encountered in diagnosis without some such measure. Not so widely appreciated is the fact that the serum amylase often fails us, particularly if the episode is mild or the patient is not seen within the first few days. Clearly, any measure of the outpouring of amylase from the pancreas that improves upon the serum concentration should have great practical value.

Though much has been written about urinary amylase, the data and conclusions are conflicting, and in consequence urinary amylase excretion is infrequently used in practice. Since amylase is freely excreted by the kidney it seemed reasonable, on a little reflection, to expect the urinary excretion to give information when the serum concentration could not. This is seen from a consideration of the following