Amylase Isoenzymes

CPT: 82150(x2)
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Synonyms

  • Amylase Fractionation
  • Isoamylase
  • Pancreatic Amylase
  • Salivary Amylase

Expected Turnaround Time

2 - 3 days


Related Documents


Specimen Requirements


Specimen

Serum (preferred); lithium heparin plasma is acceptable.


Volume

2 mL


Minimum Volume

1 mL


Container

Red-top tube, gel-barrier tube, or green-top (heparin) tube


Collection

Separate serum or plasma from cells within 30 minutes of collection.


Storage Instructions

Room temperature; stable for seven days. Stable refrigerated for one month.


Causes for Rejection

Hemolysis; use of anticoagulants other than lithium heparin (Citrate and fluoride inhibit the assay reaction.)


Test Details


Use

Evaluate parotitis and pancreatic disease. Amylase is primarily produced in the pancreas and salivary glands. Isoenzymes may be used to determine the source of an elevated amylase concentration. Measurement of pancreatic amylase activity is of value in diagnosing pancreatitis and other pancreatic disorders that result in the elevation of serum and urine amylase.


Limitations

Patients with macroamylase may have elevated pancreatic amylase results. The elevation is due to the higher than normal level of pancreatic amylase in the macroimmune complex. This elevated pancreatic amylase is not diagnostic for pancreatitis, however, measurement of an elevated pancreatic amylase in urine is confirmatory of pancreatitis, pancreatic trauma, or pancreatic carcinoma since macroamylases are too large for renal clearance (see Additional Information).


Methodology

Total amylase: enzymatic; pancreatic and salivary amylase: salivary amylase is inhibited by specific antibodies and the remaining pancreatic amylase is determined by an enzymatic, colorimetric method. Salivary amylase is calculated as the difference between the total and pancreatic amylase.


Reference Interval

See tables.

• Pancreatic amylase:

Age

Male (U/L)

Female (U/L)

0 to 1 y

Not established

Not established

2 to 17 y

12–40

12–40

18 to 60 y

14–55

14–55

>60 y

13–72

13–72

• Total amylase:

Age

Male (U/L)

Female (U/L)

0 to 30 d

22–92

22–92

31 d to 6 m

8–71

8–71

7 m to 1 y

24–98

24–98

>1 y

31–110

31–110

• Salivary amylase:

Age

Male (U/L)

Female (U/L)

All

11–83

11–83


Additional Information

Macroamylases are sometimes present in sera. These rare forms are probably complexes between ordinary amylase (usually S-type) and IgA, IgG, or other high molecular weight plasma proteins. These macroamylases cannot be filtered through the glomeruli of the kidney because of their large size (MW >200,000) and are thus retained in the plasma where their presence may increase amylase activity to some six- to eightfold over that observed in health. In macroamylasemia, amylase activity in the urine is lower than normal, since less amylase is cleared by the kidneys. No clinical symptoms are associated with this disorder; however, many of these cases have been detected following investigation of abdominal pain.


LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
123110 Amylase Isoenzymes 24333-7 001396 Amylase U/L 1798-8
123110 Amylase Isoenzymes 24333-7 123111 Pancreatic Amylase, S U/L 1805-1
123110 Amylase Isoenzymes 24333-7 123113 Salivary Amyl. Calc. U/L 1809-3

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