[Lipase and total amylase and its isoenzymes as markers of pancreatic injury in patients treated with antiepileptic drugs].

OBJECTIVE The study of the serum lipase and total amylase and its isoenzymes as biochemical markers of pancreatic injury in patients treated with valproic acid and other enzyme-inducing antiepileptic drugs. METHOD The serum activities of lipase and total amylase and its isoenzymes were determined in 41 patients treated in monotherapy with valproic acid, 50 patients in mono/polytherapy with phenytoin, phenobarbital and carbamazepine, and 30 healthy controls. RESULTS In the first group of patients a clinically significant difference in relation to the control group was not obtained for any of the enzyme activities studied; however, in the group of patients treated with enzyme-inducing antiepileptic drugs clinically significant differences were obtained for lipase and pancreatic amylase. In this group of patients, the activity of pancreatic amylase was clearly increased in two cases (4%), suggesting the existence of a pancreatic damage. In the patients studied, the total amylase showed a poor specificity as a biochemical marker for pancreatic injury, and the greater serum activity observed in one case corresponds to an increase of the salivar isoenzyme. The sensitivity of the lipase is smaller than amylase pancreatic isoenzyme. CONCLUSIONS In patients treated with antiepileptic drugs, the determination of the pancreatic isoenzyme of amylase would be of interest even in absence of clinical signs for acute pancreatitis.