Search tips
Search criteria 


Logo of bmjcrBMJ Case ReportsVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
BMJ Case Rep. 2010; 2010: bcr0220102747.
Published online 2010 July 22. doi:  10.1136/bcr.02.2010.2747
PMCID: PMC3027381
Reminder of important clinical lesson

Abdominal pain and hyperamylasaemia—not always pancreatitis


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.

Articles from BMJ Case Reports are provided here courtesy of BMJ Publishing Group