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HelpTest ID: AMBF Amylase, Body Fluid
Reporting Name
Amylase, BFUseful For
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
Specimen Type
Body FluidOrdering 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.
Specimen Required
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.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Body Fluid | Refrigerated (preferred) | 7 days | |
| Frozen | 30 days | ||
| Ambient | 24 hours |
Reference Values
An interpretive report will be provided
Day(s) Performed
Monday through Sunday
Test Classification
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
82150
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| AMBF | Amylase, BF | 1795-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| AMBFL | Amylase, BF | 1795-4 |
| FLD21 | Fluid Type, Amylase | 14725-6 |
Clinical Information
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.
Interpretation
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.
Clinical Reference
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
Report Available
Same day/1 to 2 daysMethod Name
Enzymatic Colorimetric
Forms
If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728) with the specimen.
mml-gi-pancreas-pancreatitis