• Amylase & lipase are enzymes derived from pancreatic acinar cells
  • Both have their own advantages
  • Where possible lipase is recommended as the assay of choice

  • Serum amylase remains most commonly used in clinical practice
  • Diagnosis suggested when level is greater than 3x upper range of normal (>300 IU/L)
  • Less accurate than lipase for diagnosis:
    • May remain within normal levels in as many as one fifth of patients
    • Levels rise quickly and have a serum half life of 2 hours - a single peak in amylase may be missed
  • Non-specific and may be elevated due to other causes
  • Level of elevation does not necessarily correlate with disease severity or prognosis
  • Diagnosis suggested when level is greater than 600 IU/L
  • Greater overall accuracy than amylase
    • Recommended as assay of choice by BSG
    • More sensitive and specific for diagnosis
    • Concentrations are increased for up to 14 days after onset of pancreatitis