Pancreatic hyperenzymemia: clinical significance and diagnostic approach.

An increase in the serum concentration of pancreatic enzymes (amylase and lipase) is commonly an expression of inflammatory or neoplastic pancreatic disease. However, an elevation of pancreatic enzymes, generally mild, may be a non-specific phenomenon without any clinical implication. The large spreading of the serum pancreatic enzymes dosage in clinical practice, particularly in emergency rooms, results in a large number of patients with elevated amylase and/or lipase serum levels without clinical evidence of pancreatic disease [1, 2]. This generally involves a ever-increasing number of instrumental and biochemical investigations to exclude pancreatic disorders, with a waste of resources from a costeffective point of view. This review emphasizes the biological mechanisms behind these serological alterations, the possible causes, the clinical implications and the diagnostic approach.