Hyperamylasaemia and Multiple Myeloma

Abstract

This case report describes a 42-year-old Caucasian woman who presented with persistent hyperamylasaemia and no evidence of pancreatic pathology. Further investigations resulted in a diagnosis of light-chain multiple myeloma. Amylase production by epithelial tumours has been well documented but the association with multiple myeloma has only been described in a small number of cases. The link does not appear to be immunoglobulin class-specific but the association with Bence Jones myeloma is unusual. The common features in this group of patients have been extensive extramedullary spread with a high tumour mass and a poor prognosis. This case was similar in that the patient showed very rapid disease activity developing extensive metastatic lesions and treatment ultimately proved unsuccessful. The amylase concentrations have been shown to decrease in response to treatment and increase at times of relapse and it has been proposed that it may be useful as a tumour marker in these patients. This case study adds to the pool of patents with this unusual association.

Hyperamylasaemia: don’t forget undiagnosed carcinoma

“…A common feature of the myeloma cell lines associated with hyperamylasaemia was a translocation of chromosome 1, which harbours the gene for amylase. [7][8][9] Shigemura et al 10 reported that in multiple myeloma with hyperamylasaemia, a majority of cases were due to salivary-type hyperamylasaemia (sialyl salivary-type amylase). In patients with amylase-producing multiple myeloma, the onset of hyperamylasaemia was associated with a rapid disease progression associated with extensive bone destruction and increased mortality.…”

α‐Amylase Kinetic Test in Bodily Single and Mixed Stains

“…As α‐amylases are secreted into the digestive system, small amounts diffuse into the bloodstream and are eliminated through urine and perspiration; so are commonly found in several biological fluids, especially urine, perspiration, and, in addition, in vaginal secretions, breast milk, tear fluid, serum, male and female reproductive tissues, and feces (9–13); however, with the exception of feces, no other body fluid approaches the level of amylases activity in dried stains from the aforementioned biological fluids. In some pathological conditions, especially in pancreatic disorders such as pancreatitis (14) and in several kind of tumors affecting the digestive apparatus (15), the α‐amylase levels may be drastically altered and tissue normally not expressing these enzymes may become relevant sources of α‐amylases (16). α‐amylases are also found in the liver, fallopian tubes, and small intestine; inflammation of these tissues also increases levels.…”