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Reminder of important clinical lesson
Abdominal pain and hyperamylasaemia—not always pancreatitis
  1. Sally Slack1,
  2. Ianthe Abbey2,
  3. Dominic Smith2
  1. 1Department of Clinical Biochemistry, York Hospital, York, UK
  2. 2Department of Paediatrics, York Hospital, York, UK
  1. Correspondence to Sally Slack, sally.slack{at}york.nhs.uk

Summary

A raised serum amylase concentration, at least four times the upper limit of normal (ULN), is used to support the diagnosis of acute pancreatitis in a patient presenting with abdominal pain. The authors report a case of toxic shock syndrome complicated by a raised serum amylase concentration that peaked at 50 times the ULN in a patient with recurrent abdominal pain. The commonest cause of hyperamylasaemia is pancreatic; however, further investigation of serum lipase and amylase isoenzyme studies found this to be of salivary origin and attributable to soft tissue inflammation of the salivary gland. This case highlights the need to consider non-pancreatic causes of hyperamylasaemia.

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  • Competing interests None.

  • Patient consent Obtained.

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