Abstract
We have found that the maeasurement of serum pancreatic isoamylase (P-type amylase) in patients with digestive diseases helps us to diagnose pancreatic diseases. The isoamylase was assayed utilizing electrophoresis. The ratio of serum P-type amylase to serum total amylase was below 20 per cent in 20 of the 247 patients (8.196). These 20 consist of 10 patients with chronic pancreatitis (of these 10, seven patients also had pancreatolithiasis); 5 patients with pancreatic cancer involving 4 intra- and post-operative irradiated cases; one patient with malabsorption syndrome after Billoth II gastrectomy; plus 4 other cases.
Among 47 patients on whom the pancreozymin secretin test (exocrine pancreatic function test) was performed, the low levels of P-type amylase were found in all of 6 cases who showed both amylase output and maximum bicarbonate concentration, in 2 out of 5 cases who showed amylase output or maximum bicarbonate concentration and in none out of 36 cases who showed normal values in the pancreozymin secretin test. Thus, it is suggested that low levels of P-type amylase reflect a decrease of exocrine pancreatic function.
Of the above 20 patients with decreased serum P-type amylase, serum total amylase levels were not decreased in any of the 20 patients, serum elastase 1 levels were decreased in 9 of the 20 (45%), serum carotene levels were abnormally low in 12 out of 15 patients (80%), glucose intolerance was found in 12 of the 20 patients (60%), and insulin was given for the treatment of diabetes in 6 of the 20 patients (30%).
