Pancreatic hyperenzymemia: new advances in the field of clinical-diagnostic approach, with particular attention about Gullos syndrome - Minerva

Medica 2012 October;103(5):393-412 - Minerv...

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MINERVA MEDICA

Minerva Medica 2012 October;103(5):393-412

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Pancreatic hyperenzymemia: new advances in the field of clinical-diagnostic approach, with particular attention
about Gullos syndrome
Catanzaro R., Italia A.
Unit Operativa Complessa di Medicina Interna A. Francaviglia, Dipartimento di Medicina Interna e Patologie Sistemiche,
Azienda Ospedaliero-Universitaria, Policlinico-Vittorio Emanuele, Catania, Italia
An increase in serum levels of pancreatic enzymes is a well-known manifestation of pancreatic disease, especially of
inflammatory or neoplastic nature, even if several extrapancreatic diseases can equally cause that increase. In addition to this
pathological type of hyperenzymemia, different non-pathological forms have also been identified, including
macroamylasemia, salivary, and mixed salivary and pancreatic hyperamylasemia, in all of which only amylase elevations are
seen. Nevertheless, in 1996 a new syndrome characterized by an abnormal, chronic, benign increase in levels of serum
amylase, pancreatic isoamylase, lipase and trypsin, asymptomatic and usually discovered incidentally, was described for the
first time by Lucio Gullo et al. Hyperamylasemia/hyperlipasemias observation is nowadays on the increase because general
practitioners tend to include more frequently amylase and lipase in routine blood tests and, moreover, because the constant
evaluation of this biochemical alteration in the Emergency Unit: for this reason, this syndrome was clearly identified only
recently. Therefore, its characterized by serum elevation of all pancreatic enzymes in the absence of underlying diseases; it
occurs in either sporadic or familial form and it persists over time with considerable fluctuation in serum enzyme
concentrations, including frequent normalizations. Proper diagnosis of this form of hyperenzymemia is important because it
reassures the subjects having this anomaly that the syndrome is benign, and because it can prevent multiple and expensive
diagnostic tests or useless hospitalizations or therapies.
language: Italian
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http://www.minervamedica.it/en/journals/minerva-medica/article.php?cod=R10Y2012N05A0393[09-Jan-15 1:44:19 PM]