Differential Diagnosis for Elevated Amylase and Normal Lipase
- Single most likely diagnosis:
- Salivary gland pathology (e.g., salivary gland inflammation or tumor): This is because amylase is also produced in the salivary glands, and an elevation in amylase with normal lipase levels could indicate a problem with the salivary glands rather than the pancreas.
- Other Likely diagnoses:
- Macroamylasemia: A condition where amylase is bound to immunoglobulins, leading to elevated amylase levels without any actual pancreatic or salivary gland disease.
- Renal failure: Decreased renal clearance of amylase can lead to elevated serum levels, even in the absence of pancreatic disease.
- Ovarian cysts or tumors: Some ovarian pathologies can produce amylase, leading to elevated levels.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pancreatic cancer: Although less common, some pancreatic cancers can produce amylase, and it's crucial to rule out this potentially deadly diagnosis.
- Intestinal obstruction or infarction: These conditions can cause elevated amylase levels due to the release of amylase from the intestinal mucosa.
- Rare diagnoses:
- Lung cancer: Some lung cancers can produce amylase, although this is a rare cause of elevated amylase levels.
- Medullary thyroid carcinoma: This rare type of thyroid cancer can also produce amylase.
- Pheochromocytoma: A rare tumor of the adrenal gland that can produce amylase in some cases.