What Causes Elevated Lipase And Amylase Levels?
Need follow up tests
Detailed Answer:
Hello,
I can understand your concern for abnormal lab results.
1) elevated amylase and lipase levels are suggestive of inflammation in pancreas and/or areas surrounding pancreas.
2) But your USG abdomen did not reaveal any abnormality in pancreas or areas around pancreas.
3) Most common causes for pancreatitis are alcohol, gall stone, some structural abnormality in pancreatic duct (which can not be detected on USG abdomen). Your USG abdomen also ruled out gall stone.
4) As you do not have any symptoms and your lab values are marginally elevated, I would recommend you to repeat these values after 15-20 days or when you develop abdominal pain in future. Also to recommend, you should do MRI abdomen with MRCP to check structural abnormality in pancreatic duct.
Hope I answered your query. If you have any further doubt, i would be happy to help you.
Have a good day!
Is better do CT Abdomen or MRI, which shows structural abnormality in pancreatic
best? Best regards, XXXX
You consider my lipase and amalyse level slightly elevated, even they are 2x higher than the lab XXXXXXX reference. Shouldn't I worry much because of these levels, aren't they so bad?
Thanks again. Hope you don't mind that I asked you these questions.
Lipase level is 2X, require detail evaluation to find cause
Detailed Answer:
Hello,
1) For pancreas and pancreatic duct - MRI with MRCP is best. For general abdominal evaluation - CT scan abdomen with contrast is best.
2) Amylase level is marginally elevated. Amylase level is more sensitive for any acute pathology of pancreas.
3) You are right, lipase level is double the expected normal value. Higher lipase level suggest chronic pathology related to pancreas.
My concern was not to worry about seriousness of condition as far as you are completely asymptomatic. But definitely you require further evaluation to find out reason for these persistent abnormal values.
In further evaluation, I would recommend to add CA-19-9 tumor marker test also to rule out pancreatic cancer.
The problem for me to find the cause. The question still is to do CT general abdomen or MRI for panreaas. Does MRI show pancreas as well as general abdomen? In my understanding MRI might be more useful because can show pancreas pathology (if any) and other abdomen organs?
Please advice which one to do, very expensive tests for me, don't want to do both, only one. Thanks a lot.
Personally I would recommend MRI
Detailed Answer:
Hello,
I apologize for not looking in to the CA 19-9.
Till now, there is no cause was found for these abnormal values.
Radio-logical investigations are classified in two -
a) Diagnostic investigation, which diagnose probable causes (like USG abdomen)
b) Confirmatory investigation confirms the diagnosis which was not sure in previous investigation.
1) CT scan is best for malignant cause, intestines, abdominal wall.
2) Based on your lab values, probable pathology can be in the pancreas (for which no any additional test is required). So next step would be to confirm the condition which was suspected in previous investigation.
3) Advantage of MRI with MRCP is that it is best test for pancreatic duct, bile duct and general MRI give idea about overall abdomen findings.
Personally I would recommend MRI + MRCP for you, but this also depends on radiologist's experience on interpreting findings on MRI and CT.
Therefore, you must discuss this issue with radiologist before selecting which test to undergo.
Regards
Thanks a lot.
MRCP for pancreatic duct and bile duct
Detailed Answer:
Hello,
I apologize for late reply.
MRCP is type/part of MRI study of abdomen. In this study, settings are changed for better visualization of pancreatic duct and bile duct.