Amylase, Body Fluid

Body fluid (eg, ascitic fluid, pleural fluid, etc)

1 mL

0.3 mL (Note: This volume does not allow for repeat testing.)

Clean container, no preservative

Pancreatitis with or without pseudocyst formation or pancreatic pleural fistula is the most common cause of amylase elevation in pleural fluid. Rupture of the esophagus is the second most common group and malignant effusion is the third.¹ Other causes include pancreatic ascites and pancreatic duct trauma. Defect in the wall of the gastrointestinal tract (eg, perforated peptic ulcer) will allow pancreatic secretion to enter the peritoneal cavity. Similarly, peritoneal fluid amylase elevations may be found in the presence of necrotic bowel. Peritoneal fluid, containing such amylase, can find its way into a pleural space.

In collection of ascitic fluid, the localization of the catheter is likely to affect the chemistry result.² Oxalate or citrate depress results. Lipemic sample may contain inhibitors which falsely depress results. Benign ovarian cyst fluids may have significant amylase activity.

Enzymatic

• Peritoneal: 88−109 U/L

• Pleural:

− Transudate: Not established

− Exudate: Not established

• Synovial: Not established

The method performance specifications have not been established for this test in body fluid. The test result should be integrated into the clinical context for interpretation.

Most patients with pancreatic ascites have high peritoneal fluid amylase as well as amylase elevations in serum and urine. Pancreatitis may present with pleural effusion. Of 34 patients who had high amylase in pleural fluid associated with neoplasms, 18 had carcinoma of lung. Other tumors were gynecologic, gastrointestinal, lymphoma, breast and malignancy of unknown origin.¹