Amylase-creatinine Clearance Ratio Research Articles

The amylase creatinine clearance ratio in acute pancreatitis.

One hundred and twenty-two patients have been studied in order to evaluate the usefulness of the amylase creatinine clearance ratio (ACCR) as a simple diagnostic test for acute pancreatitis. Sixteen out of 17 patients with acute pancreatitis had significant elevations in ACCR; in only 10 of these 17 cases was the serum amylase greater than 1200iu/l. The mean ACCR was within the normal range in control patients, in patients with chronic gastro-intestinal disease and in patients with acute abdominal conditions excluding pancreatitis; however, the mean serum amylase was significantly greater in patients with acute abdominal conditions than in the control group (P less than 0-05). The ACCR remained significantly elevated in patients with acute pancreatitis for longer than either serum or urine amylase values. The findings of the study suggest that the amylase creatinine clearance ratio is a simple yet reliable diagnostic test which could be used when screening patients suspected of having acute pancreatitis.

Asymptomatic transient hyperamylasemia after a large intravenous dose of steroid hormone

Asymptomatic transient hyperamylasemia accompanied with hyperamylasuria immediately after an intravenous dose of 1 gm methylprednisolone has been observed in renal homotransplantation patients. Similar phenomena have also been seen in the other operative patients who received certain amounts of steroid hormone intravenously during their procedure. These cases of hyperamylasemia and hyperamylasuria were studied in detail including time-sequence observation, amylase-creatinine clearance ratio, and amylase isoenzyme analysis. The hyperamylasemia is not due to the general anesthesia or the surgical procedure. It is apparently not due to simple retention of enzyme from poor kidney function. The source of hyperamylasemia is the pancreas mediated by large intravenous doses of steroid hormone.

Amylase creatinine clearance ratio after biliary surgery.

The amylase creatinine clearance ratio (ACCR) is considered to be a more sensitive index of acute pancreatitis than the serum amylase level. Serial ACCR estimations were undertaken in 25 patients undergoing an elective cholecystectomy. Using accepted criteria, 28% of these patients developed, in the postoperative period, biochemical evidence of pancreatic gland damage, although the serum amylase level remained normal. This raised ACCR was particularly noted in patients who had undergone an exploration of the common bile duct. The ACCR would appear to be a more sensitive index of pancreatic gland disruption secondary to biliary surgery than the serum amylase level.