Increased Serum Lipase with Associated Normoamylasemia in Cancer Patients (Technical Briefs‪)‬

Measurements of the activity of both lipase (triacylglycerolacylhydrolase, EC 3.1.1.3) and a-amylase (EC 3.2.1.1) in serum are commonly used as aids in the diagnosis and follow-up of acute and recurrent pancreatitis (1); 19% of pancreatitic patients present with normal serum amylase (2), thus leaving lipase as the main hematochemical marker of this disease in a substantial number of patients. Lipase and amylase are increased also in conditions other than pancreatitis, such as several nonmalignant hepatobiliary and gastrointestinal diseases, sepsis, renal failure, pulmonary failure, and subdural bleeding (1-4). In 1987, Stein et al. (5) reported on a non-Hodgkin's lymphoma patient with major lipase activity (up to seven times the upper reference value), with no parallel increase in amylase; in this case, the authors demonstrated a specific immunoglobulin G with high affinity for lipase as the cause of increased serum lipase activity.