Hyperamylasemia in Inflammatory Bowel Disease: Report of a case with literature review

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2007 (EN)
Hyperamylasemia in Inflammatory Bowel Disease: Report of a case with literature review (EN)

G.V. Tsianos, E.V. Tsianos, K.Ç. Katsanos, G. Kolios,

SUMMARY It has been suggested that in patients with inflammatory bowel disease (IBD) there is subclinical pancreatic involvement. A 22-year-old male with Crohn’s disease of the terminal ileum, diagnosed four years earlier was admitted in our hospital because of persistent asymptomatic mild hyperamylasemia (serum amylase 135 UI/ml) during azathioprine treatment. Patient personal history was unremarkable and there was no evidence of any other extraintestinal manifestations. Physical examination was within normal limits and upper gastrointestinal tract endoscopy with abdominal MRI and MRCP were normal. During admission it was decided to switch from azathioprine to methotrexate in order to exclude the possibility of azathioprine-related idiopathic pancreatitis. However, serum amylase values did not subsided. An additional MRCP performed at that time was normal. Subsequent serum isoamylase determination showed pancreatic isoenzyme predominance (P-isoenzyme). As patient transaminases were markedly increased during methotrexate therapy, it was decided to finally switch the patient again to azathioprine as the diagnosis of chronic idiopathic pancreatitis secondary to Crohn’s disease seemed more probable. On the two-year laboratory follow up the patient still had mild asymptomatic hyperamylasemia. Differential diagnosis of hyperamylasemia in IBD includes overview of general and disease specific causes of hyperamylasemia, as well as laboratory investigative methods on amylase typing and subtyping. In the absence of specific indications this hyperamylasemia requires no further investigation. Key words: hyperamylasemia, Crohn’s disease, ulcerative colitits, isoamylases. (EN)




Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 17, No 3 (2004) (EN)

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