Test Catalog

Test Id : AMISO

Amylase, Isoenzymes, Serum

Useful For
Suggests clinical disorders or settings where the test may be helpful

Ruling out salivary amylase as the cause of elevated serum amylase

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
AMYSE Amylase, Total, S Yes, (Order AMS) Yes
AMYPA Amylase, Pancreatic, S No Yes
AMYSA Amylase, Salivary, S No Yes

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Total amylase and pancreatic amylase are measured in the submitted serum sample. Salivary amylase is calculated as the difference between the two measured results (salivary amylase = total amylase-pancreatic amylase).

Method Name
A short description of the method used to perform the test

AMYSE, AMYPA: Colorimetric Rate Reaction

AMYSA: Calculation

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Amylase, Isoenzymes, S

Aliases
Lists additional common names for a test, as an aid in searching

Isoenzymes

Salivary Amylase

Pancreatic Amylase

AMYISO

Amylase Fractionation

Pancreatic Isoamylase

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Total amylase and pancreatic amylase are measured in the submitted serum sample. Salivary amylase is calculated as the difference between the two measured results (salivary amylase = total amylase-pancreatic amylase).

Specimen Type
Describes the specimen type validated for testing

Serum

Necessary Information

Age and sex of patient are required.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL

Collection Instructions:

1. Serum gel tubes should be centrifuged within 2 hours of collection.

2. Red-top tubes should be centrifuged and the serum aliquoted into a plastic vial within 2 hours of collection.

Forms

If not ordering electronically, complete, print, and send Gastroenterology and Hepatology Client 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

See Specimen Required

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis 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
Serum Frozen (preferred) 30 days
Refrigerated 30 days
Ambient 7 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Ruling out salivary amylase as the cause of elevated serum amylase

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Total amylase and pancreatic amylase are measured in the submitted serum sample. Salivary amylase is calculated as the difference between the two measured results (salivary amylase = total amylase-pancreatic amylase).

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

The amylase enzymes are a group of hydrolases that degrade complex carbohydrates (starches) into simple sugars. The pancreas and salivary glands have amylase concentrations that are orders of magnitude greater than any other tissue. These two amylase isoenzymes, pancreatic and salivary, are present in serum.

 

Pancreatic and salivary amylase isoenzymes can be measured in serum at both physiologic concentrations (within the age-specific reference interval), and elevated concentrations indicate hyperamylasemia. Hyperamylasemia can result from either increased rate of release of amylase into blood or decreased metabolic clearance of the enzyme (ie, macroamylase).

 

Routine amylase laboratory tests measure total amylase activity in serum and do not differentiate between amylase isoenzymes. Differentiation of amylase isoenzymes is useful in cases where amylase elevations are not thought to be from a pancreatic source.

 

Pancreatic amylase may be elevated due to pancreatitis as well as other conditions in which pancreatic amylase is released (eg, cannulation of the pancreatic duct) or absorbed (eg, loss of bowel integrity) into the blood. Serum pancreatic amylase should always be interpreted in a context of total amylase to determine the relative contribution of salivary and pancreatic isoenzymes.

 

Hyperamylasemia due to salivary amylase may occur when salivary gland disease is present. Salivary amylasemia may also be observed in conditions where there is no clinical evidence of salivary gland disease such as chronic alcoholism, postoperative states, lactic acidosis, anorexia nervosa or bulimia, and malignant neoplasms that secrete amylase.

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.

AMYLASE, TOTAL

0-30 days: < or =6 U/L

31-182 days: 1-17 U/L

183-365 days: 6-44 U/L

1-3 years: 8-79 U/L

4-17 years: 21-110 U/L

> or =18 years: 28-100 U/L

 

AMYLASE, PANCREATIC

0-<24 months: < or =20 U/L

2-<18 years: 9-35 U/L

> or =18 years: 13-53 U/L

 

AMYLASE, SALIVARY

0-<18 years: Not established

> or =18 years: <87 U/L

Interpretation
Provides information to assist in interpretation of the test results

Increased concentrations of total amylase activity in conjunction with increased concentration of specific amylase isoenzymes may aid in differentiating the source of amylase (pancreatic versus salivary).

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Amylase results may be elevated in patients with macroamylase. Macroamylase refers to a high-molecular weight form of amylase that is present in a patient's serum. Different causes of macroamylase have been suggested, the most common being amylase complexed with an immunoglobulin. The large size of the macroamylase complex prevents its excretion in the urine. By utilizing serum lipase and urinary amylase, the presence or absence of macroamylase may be determined.

 

Total amylase measurement should be used for diagnosis and management of pancreatitis and evaluation of pancreatic function. Amylase isoenzyme determination is not necessary for these situations.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Panteghini M: Laboratory evaluation of pancreatic diseases. Biochimica Clinica. 2010;34(1):19-25

2. Rifai N, Horvath AR, Wittwer CT: Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. 8th ed. Elsevier; 2018

3. Pieper-Bigelow C, Strocchi A, Levitt MD: Where does serum amylase come from and where does it go? Gastroenterol Clin North Am. 1990 Dec;19(4):793-810

4. Azzopardi E, Lloyd C, Teixeira SR, Conlan RS, Whitaker IS: Clinical applications of amylase: Novel perspectives. Surgery. 2016 Jul;160(1):26-37

Method Description
Describes how the test is performed and provides a method-specific reference

Total amylase:

The liquid Roche amylase method is an enzymatic colorimetric test using 4,6-ethylidene-(G7) p-nitrophenyl-(G1)-alpha-D-maltoheptaoside (ethylidene-G7PNP), cleaved under the catalytic action of alpha-amylases. The G2PNP, G3PNP and G4PNP fragments formed are completely hydrolyzed to p-nitrophenol and glucose by alpha-glucosidase. The color intensity of the p-nitrophenol formed is directly proportional to the alpha-amylase activity. It is determined by measuring the increase in absorbance.(Package insert: AMYL2 reagent. Roche Diagnostics; 12/2018)

 

Pancreatic amylase:

After immunoinhibition with antibodies against human salivary alpha-amylase, the amount of pancreatic alpha-amylase in a sample is selectively determined by an enzymatic colorimetric method using the substrate ethylidene-G7PNP.(Package insert: Alpha-Amylase EPS Pancreatic. Roche Diagnostics; 05/2019)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

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 Sunday

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.

1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

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 Regional Manager. 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 cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

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.

82150 x 2

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
AMISO Amylase, Isoenzymes, S 24333-7
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.
AMYPA Amylase, Pancreatic, S 1805-1
AMYSA Amylase, Salivary, S 1809-3
AMYSE Amylase, Total, S 1798-8

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Create a PDF

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports