Test Id : AMBF
Amylase, Body Fluid
Useful For
Suggests clinical disorders or settings where the test may be helpful
Evaluation of patients with a pathological accumulation of fluid to determine whether pancreatic inflammation, pancreatic fistula, or esophageal rupture may be contributing
Aiding in the diagnosis of pancreatitis
Method Name
A short description of the method used to perform the test
Enzymatic Colorimetric
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Amylase Frac, Body Fluid
Amylase, Macro, Body Fluids
Specimen Type
Describes the specimen type validated for testing
Body Fluid
Ordering Guidance
For pancreatic cyst fluid specimens, order AMLPC / Amylase, Pancreatic Cyst Fluid. Testing will be changed to AMLPC if this test is ordered on that specimen type.
Necessary Information
1. Date and time of collection are required.
2. Specimen source is required.
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| FLD21 | Fluid Type, Amylase |
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Specimen Type: Body fluid
Preferred Source:
-Peritoneal fluid (peritoneal, abdominal, ascites, paracentesis)
-Pleural fluid (pleural, chest, thoracentesis)
-Drain fluid (drainage, Jackson Pratt [JP] drain)
-Pericardial fluid
Acceptable Source: Write in source name with source location (if appropriate)
Collection Container/Tube: Sterile container
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Centrifuge to remove any cellular material and transfer into a plastic vial.
2. Indicate the specimen source and source location on label.
Forms
If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
0.5 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
| Anticoagulant or additive, breast milk, nasal secretions, gastric secretions, bronchoalveolar lavage (BAL or bronchial washings), feces, colostomy/ ostomy, saliva, sputum, urine, vitreous fluid, or pancreatic cyst | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Body Fluid | Refrigerated (preferred) | 7 days | |
| Ambient | 24 hours | ||
| Frozen | 30 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Evaluation of patients with a pathological accumulation of fluid to determine whether pancreatic inflammation, pancreatic fistula, or esophageal rupture may be contributing
Aiding in the diagnosis of pancreatitis
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Pleural fluid:
Amylase-rich pleural effusions are commonly associated with pancreatitis, esophageal rupture, malignancy, pneumonia, and liver cirrhosis.(1) Pleural fluid amylase measurement is not routinely indicated though may help to narrow the differential due to these causes. Results should be interpreted in conjunction with serum measurement usually as a ratio of pleural fluid to serum amylase. The ratio of pleural fluid to serum amylase in effusions caused by pancreatic disease is much higher (mean + or - SD = 18 + or - 6.3) versus non-pancreatic disease (4.8 + or - 1.3) (P = 0.003).(2) Isoform analysis revealed that pancreatic amylase is diagnostic of pancreatitis-related pleural effusions, whereas salivary amylase isoforms are more often associated with esophageal rupture and malignancy.(3)
Peritoneal fluid:
The digestive enzymes amylase and lipase can be measured in the identification of pancreatic fluid in the peritoneal cavity. Concentrations are expected to be elevated and at least several-fold times higher in fluid of pancreatic origin compared to simultaneous concentrations in serum.(4) In contrast, amylase concentration in ascites of non-pancreatic origin was approximately half the plasma value.(5)
Drain fluid:
Amylase might be measured in a drain fluid to aid in the identification of internal pancreatic fistulas due to chronic pancreatitis or formation of a fistula after surgery.(6,7) Comparison to serum concentrations is recommended with elevations several-fold higher than blood being suggestive of the presence of pancreatic fluid in the drained cavity.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
An interpretive report will be provided
Interpretation
Provides information to assist in interpretation of the test results
Peritoneal and drain fluid amylase activity in non-pancreatic peritoneal fluid is often less than or equal to the serum amylase activity. Ascites associated with pancreatitis typically has amylase activity at least 5-fold greater than serum.(1)
Normal pleural fluid amylase activity is typically less than the upper limit of normal serum amylase and has a ratio of pleural fluid amylase to serum amylase ratio less than 1.0.(3)
All Other Fluids: Body fluid amylase activity may become elevated due to the presence of pancreatitis, esophageal rupture, or amylase producing neoplasms. Results should be interpreted in conjunction with serum amylase and other clinical findings.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
In very rare cases, gammopathy, in particular type IgM (Waldenstrom macroglobulinemia), may cause unreliable results.
Icodextrin-based drugs may lead to decreased amylase results.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Burgess LJ. Biochemical analysis of pleural, peritoneal and pericardial effusions. Clin Chim Acta. 2004;343:61-84
2. Joseph J, Viney S, Beck P, Strange C, Sahn SA, Basran GS. A prospective study of amylase-rich pleural effusions with special reference to amylase isoenzyme analysis. Chest. 1992;102:1455-1459
3. Sahn SA. Getting the most from pleural fluid analysis. Respirology. 2012;17:270-277
4. Robert JH, Meyer P, Rohner A. Can serum and peritoneal amylase and lipase determinations help in the early prognosis of acute pancreatitis? Ann Surg. 1986;203:163-168
5. Runyon BA. Amylase levels in ascitic fluid. J Clin Gastroenterol. 1987;9(2):172-174
6. Lipsett PA, Cameron JL. Internal pancreatic fistula. Am J Surg. 1992;163(2):216-220
7. Kaman L, Behera A, Singh R, Katariya RN. Internal pancreatic fistulas with pancreatic ascites and pancreatic pleural effusions: recognition and management. ANZ J Surg. 2001;71(4):221-225
8. Nandakumar V, Dolan C, Baumann NA, Block DR. Effect of pH on the quantification of body fluid analytes for clinical diagnostic testing. Am J Clin Path. 2019;152(S1):S10-S11
Method Description
Describes how the test is performed and provides a method-specific reference
The liquid Roche amylase method is an enzymatic colorimetric test using 4,6-ethyliden (G7)-p-nitrophenol (G1)-alpha, D-maltoheptaoside (ethylidene-G7PNP) as a substrate. Human salivary and pancreatic amylases convert the substrate at approximately the same rate. The alpha-amylase cleaves the substrate into G2, G3, G4 PNP fragments. The G2 and G3 and G4 PNP fragments are further hydrolyzed by an alpha-glucosidase to yield p-nitrophenol and glucose. The rate of increase in absorbance at 415 nm (measuring the increase in p-nitrophenol) is proportional to amylase activity.(Package insert: Roche AMYL reagent. Roche Diagnostic Corp; 2018)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Saturday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
82150
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| AMBF | Amylase, BF | 1795-4 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| AMBFL | Amylase, BF | 1795-4 |
| FLD21 | Fluid Type, Amylase | 14725-6 |