AMALYSE......

[Guest guest]

Hi everyone.

Well, over the past week has undergone various bloodwork, an ab

ultrasound and a nuclear scan to look at delayed gastric emptying. All this

to try to get to the bottom of his ab pain and food aversion. Theres

periodic severe gastric reflux which did not show on the ph probe, severe

ongoing constipation and chronic mouth ulcers. All these problems are long

term and ongoing and being looked at by the GI specialist as seperate issues

We had hoped these latest investigations/ tests would shed some light on

what is happening and draw all the signs together to fall under one heading.

I was truly expecting in the end a diagnosis of EE, all semed to fit the EE

profile.

Talking indepth with the GI about EE she really does not feel EE plays any

part in s problems. I am going to respect her diagnosis and accept

EE does not figure in all this.

The ab ultrasound showed further deterioration of s kidneys, they are

both enlarged and worse than the previous renal u/sound a few months back.

There is also dilatation in the left central renal pelvis and it all

indicates a return of the PUJ obstruction. We have another appt with the

renal surgeon thisafternoon. : ( Aside from the kidneys the gallbladder,

liver etc are normal. Thats great news.

The bloodwork (FBC, Liver function, iron study, lipase/amalyse, etc etc) all

came in within range but for the amalyse. Lab range was (0 - 125) and

s was 205. The GI specialists said she had no idea what this meant,

what it might indicate, and is not following this through further except to

retest in a few weeks time. When she mentioned it might be from the

pancreas or the stomach, I relised I had not previously mentioned to her

that my mother suffers from severe pancreatitus. Kimberely, Ursula, ANYONE

do you know what an elevated amylase level can indicate?

The nuclear study was yesterday and the results had not made it to the

office for our appt thismorning, so the GI phoned for them while we were in

her rooms. It meant we were able to heae her discuss the results with the

dr in the radiography dept at the hospital and she queried with him whether

the results were severe, and dumping also was mentioned. Then she came off

the phone and said that the study was fairly normal, and that she would

review the film later in the afternoon herself. So I'm a little confused,

obviously some degree of delay showed up but she feels it is not signifigant

for us to be told.

So essentially we are back to square one, and looking at having

admitted for a few days so she can watch his eating and observe the

associated pain. We are loathe to go the tube feedng route but have no idea

what else we can do.

Dh had a lightbulb moment in the car on the way home from our appt- could

all this be associated with his kidneys? My gut reaction is no-the mouth

ulcers and GERD (although the specialist says it is not acid based but

definitely there--so is this the same as GERD or totally different? HELP!)

cannot be caused by anything to do with the kidneys surely?

Well I'm glad dh is home today for my birthday to be able to see the

specialists with me. Its really good having him at the appts after facing so

many on my own.

I just wanted to also say thanks for all the responses I have had to my

polio vaccine query- it was wonderful to get so much feedback and helped

enormously.

Take care everyone,

[Guest guest]

The lab books I have say that an elevated serum Amylase and Urine amylase well..

let me just type it in word for word-- this is from

Diagnostics Tests second edition published by SPringhouse

" Serum and Urine Amylase values in acute pancreatitis. Normal serum values are

138 to 404 amylase units/L and normal urine values are 10 to 80 amylase

units/hour "

it goes on to show a chart that talks about the Elevation of the serum levels

and what they mean and hte elevation of the urine levels and what they

mean.... " Serum amylase level rises rapidly within 3 to 6 hours after onset of

attack and May rise 40 times the normal value.. the increase is not proportional

to the severity of the attack. Elevated Urine levels reflect a rise in serum

levels, but lags 6 to 10 hours "

then it goes on to describe duration of hte elevation.. Serum levels peak 20 to

30 hours after onset and returns to normal level within 2 or 3 days, although

active inflammation of pancreas may persist, Persistant elevation suggests

pseudocyst, necrosis, or renal disease that inhibits amylase excretion. Urine

level elevation persists for 7 to 10 days and allows a retrospective diagnosis

of acute or relapsing pancreatitis when serum level registers in the normal

range. Persistant elevation of urine amylase levels in the absence of renal

disease suggests pseudocyst formation "

On another page it says this about the Implications of elevated Urine Amylase

results:

" Elevated amylase levels occur in acute pancreatitis; obstruction of the

pancreatic duct, intestines, or salivary duct;carcinoma of the head of the

pancreas; mumps; acute injury to the spleen; renal disease, with impaired

absorption; perforated peptic or duodenal ulcers; and gall bladder disease.

Depressed levels occur in chronic pancreatitis, cachexia....... "

On another page is says this about the serum amylase ... " Implications of results

" After the onset of acute pancreatitis, serum amylase levels begin to rise in 2

hours, peak at 12 to 48 hours and return to normal in 3 to 4 days. Determination

of urine levels should follow normal serum amylase results to rule out

pancreatitis. Moderate serum elevations may accompany pancreatic injury from

perforated peptic ulcer, pancreatic cancer, acute salivary gland disease,

impaired renal function, or obstruction of the common bile duct, the pancreatic

duct, or the ampulla of Vater. Levels may be slightly elevated in a patient who

is asymptomatic or who is responding unusually to therapy. "

Sorry it took me so long to get this to you! Hope it helps you some... it looks

like Kidney problems could cause the rise in the amylase...

pattie