Acute Pancreatitis Without Elevation of Amylase and Lipase

The serum level of pancreatic enzymes does not correlate with the severity of acute pancreatitis.

The presence of pancreatitis would be established by some method in a suitable clinical setting:

(1) imaging studies

(2) presence at surgery

Factors associated with low elevations in serum amylase:

(1) biliary stone etiology (OR 0.5)

(2) elevated LDL cholesterol concentration (OR 1.009)

(3) elevated triglyceride concentration (OR 1.001)

Factors associated with serum amylase and lipase in the normal range:

(1) end-stage renal disease (associated with increased urinary clearance)

The diagnosis of acute pancreatitis should not entirely rely on serum levels of these enzymes.