Nurse Berlinda is assigned to a 41-year-old client who has a diagnosis of chronic pancreatitis. The nurse reviews the laboratory result, anticipating a laboratory report that indicates a serum amylase level of:
A. 45 units/L
B. 100 units/L
C. 300 units/L
D. 500 units/L
Correct Answer: C. 300 units/L
The normal serum amylase level is 25 to 151 units/L. With chronic cases of pancreatitis, the rise in serum amylase levels usually does not exceed three times the normal value. In acute pancreatitis, the value may exceed five times the normal value. Basic lab studies for chronic pancreatitis can include a CBC, BMP, LFTs, lipase, amylase, lipid panel, and a fecal-elastase-1 value. Lipase and amylase levels can be elevated, but they are usually normal secondary to significant pancreatic scarring and fibrosis. Of note, amylase and lipase values should not be considered diagnostic or prognostic.
Option A: 45 units/L is within normal limits. Serum amylase and lipase levels may be slightly elevated in chronic pancreatitis; high levels are found only during acute attacks of pancreatitis. In the later stages of chronic pancreatitis, atrophy of the pancreatic parenchyma can result in normal serum enzyme levels because of significant fibrosis of the pancreas, resulting in decreased concentrations of these enzymes within the pancreas.
Option B: 100 units/L is within normal limits. When pancreatic tissue damage (eg. pancreatitis) or pancreatic duct is blocked, serum amylase levels increased. In acute pancreatitis, lipase levels are often very high; 10.5 times the normal level can be increased
Option D: 500 units/L is an extremely elevated level seen in acute pancreatitis. In acute pancreatitis, blood amylase increased. Sometimes up to 4-6 times the highest normal level rises.
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