Pancreatic hyperenzymemia: new advances in the field of clinical-diagnostic approach, with particular attention about Gullo’s syndrome - Minerva Medica 2012 October;103(5):393-412 - Minerv...

http://www.minervamedica.it/en/journals/minerva-medica/article.php?cod=R10Y2012N05A0393[09-Jan-15 1:44:19 PM]

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Minerva Medica 2012 October;103(5):393-412 REVIEWS

Pancreatic hyperenzymemia: new advances in the field of clinical-diagnostic approach, with particular attentionabout Gullo’s syndrome

Catanzaro R., Italia A.Unità Operativa Complessa di Medicina Interna “A. Francaviglia”, Dipartimento di Medicina Interna e Patologie Sistemiche,Azienda Ospedaliero-Universitaria, “Policlinico-Vittorio Emanuele”, Catania, ItaliaAn increase in serum levels of pancreatic enzymes is a well-known manifestation of pancreatic disease, especially ofinflammatory or neoplastic nature, even if several extrapancreatic diseases can equally cause that increase. In addition to thispathological type of hyperenzymemia, different “non-pathological” forms have also been identified, includingmacroamylasemia, salivary, and mixed salivary and pancreatic hyperamylasemia, in all of which only amylase elevations areseen. Nevertheless, in 1996 a new syndrome characterized by an abnormal, chronic, benign increase in levels of serumamylase, pancreatic isoamylase, lipase and trypsin, asymptomatic and usually discovered incidentally, was described for thefirst time by Lucio Gullo et al. Hyperamylasemia/hyperlipasemia’s observation is nowadays on the increase because generalpractitioners tend to include more frequently amylase and lipase in routine blood tests and, moreover, because the constantevaluation of this biochemical alteration in the Emergency Unit: for this reason, this syndrome was clearly identified onlyrecently. Therefore, it’s characterized by serum elevation of all pancreatic enzymes in the absence of underlying diseases; itoccurs in either sporadic or familial form and it persists over time with considerable fluctuation in serum enzymeconcentrations, including frequent normalizations. Proper diagnosis of this form of hyperenzymemia is important because itreassures the subjects having this anomaly that the syndrome is benign, and because it can prevent multiple and expensivediagnostic tests or useless hospitalizations or therapies.language: Italian

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