High Lipase Numbers with no symptoms - hyperlipasemia

For over 3 years I had flucatinig lipase numbers ranging from 1-4x over limit. The first was found incidentally while completely asymptomatic. When discovered I was given ultrasound, ct scans with constrast, ca19, colonscopy, celiac test, liver, kindey, cbc, hep, etc and all were fine. I do not drink and do not have a family history of pancreatic cancer.

Gastros diagnosed me with benign condition. However 2 years later for reassurance I had MRI on pancrease which again was normal. My gastro and his team tell me not to worry and there is nothing wrong with pancreas.

However I read these reports and it looks like I need EUS test is the test I need, which is not common here in USA. My gastro refuses to send me get one because he does not feel it's necessary. Reports below state that my so-called benheing condition is not so benign and pancreatic disease are found over 50% of time with further testing with EUS with people with Asymptomatic Pancreatic Hyperenzymemia. Some days my test are normal and some days they over slighlt over limit or 1x over limit. I have no symptoms whatsover.

So far I seen 4 gastros and they all think I have too much anxiety and not to worry but they are unaware of the latest studies.

http://www.omicsgroup.org/journals/2165-7092/2165-7092-S1-e001.pdf

Familial pancreatic hyperenzymemia is a benign condition and its pathophysiological mechanism is still unknown. An appropriate clinical and imaging follow-up should be carried out in those patients having this condition associated with familial pancreatic cancer.

An elevation in serum pancreatic enzymes in the absence of pancreatic disease is reported in the literature and defined as “benign pancreatic hyperenzymemia” or “Gullo’s syndrome” [7]. This condition can occur sporadically or in a familiar form, it is asymptomatic, and it is generally discovered incidentally. Nobody of the subjects included in this definition had been treated in the past with pancreatotoxic drugs. These authors sustain that at least one year must pass after the initial finding of pancreatic hyperenzymemia before it can be considered benign. Furthermore, they emphasize that a proper diagnosis of this condition is important because it allows the clinician to reassure the subject that this alteration is benign and does not require any kind of therapy. Nevertheless the possibility that these individuals could have an increased risk of pancreatic cancer cannot be excluded.

http://www.ncbi.nlm.nih.gov/pubmed/19296399

Chronic asymptomatic pancreatic hyperenzymemia is a benign condition in only half of the cases: a prospective study.

http://www.ncbi.nlm.nih.gov/pubmed/23042375

it's characterized by serum elevation of all pancreatic enzymes in the absence of underlying diseases; it occurs in either sporadic or familial form and it persists over time with considerable fluctuation in serum enzyme concentrations, including frequent normalizations. Proper diagnosis of this form of hyperenzymemia is important because it reassures the subjects having this anomaly that the syndrome is benign, and because it can prevent multiple and expensive diagnostic tests or useless hospitalizations or therapies.


Chronic asymptomatic hyperamylasemia unrelated to pancreatic diseases.

Summary of "Chronic asymptomatic hyperamylasemia unrelated to pancreatic diseases."

Purpose: This study was addressed to assess the clinical characteristics of patients presenting with chronic hyperamylasemia unrelated to pancreatic diseases (CHUPD). Almost all patients presenting with chronic hyperamylasemia undergo expensive, long, difficult, and often unnecessarily repeated diagnostic procedures. This is in conjunction with the poor knowledge of the fact that besides hyperenzymemia secondary to pancreatic diseases and systemic illnesses, various non-pathological forms of chronic hyperamylasemia without relevant pathologic consequence can occur in clinical practice.Material and Methods: Data of all patients with CHUPD were retrospectively reviewed (June 1997-December 2009). Fifty one patients were included in the study; median follow up was 48 months (range 8-112 months). Their pre-enrolment diagnoses were: chronic pancreatitis in 31 cases (60.7%) and recurrent pancreatitis in 13 cases (25.4%); the remaining 7 patients (13.7%) were without a specific diagnosis.Results: Our observations, supported by diagnostic procedures (Ca19-9 serum levels, abdominal ultrasonography, computed tomography and magnetic resonance, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography) revealed that CHUPD was secondary to: a) benign pancreatic hyperamylasemia, 20 patients (39.2%); b) macroamylasemia, 18 patients (35.2 %) and c) salivary hyperamylasemia, 13 patients (25.4%).Conclusions: Due to the poor familiarity with CHUPD, the occurrence of this condition quite frequently leads to unnecessarily repeated diagnostic procedures.

Affiliation

Asymptomatic pancreatic enzyme elevation is a frequent clinical problem. In almost 90% of the cases the pancreas will be normal. In the remaining cases