Increased in:

• Acute pancreatitis
• Obstructive pancreatic disease (cholecystitis, choledocholithiasis, stricture, duct sphincter spasm)
• Pancreatic carcinoma
• Pancreatic cyst and pseudocyst
• Bowel obstruction, infarction or perforation
• Intraabdominal inflammation/ acute abdomen
• Mumps
• Parotitis
• Diabetic ketoacidosis
• Infected salivary glands
• Macroamylasemia
• Renal failure
• Also slightly elevated in ruptured ectopic pregnancy and macroamylasemia
• Some drugs can increase levels of amylase, such as azathioprine, alcohol, oral contraceptives, ibuprofen, sulfonamides, furosemide, captopril, corticosteriods and hydrochlorothiazide.

Note: The magnitude of the elevation of serum amylase activity is not related to the severity of pancreatic involvement; however, the greater the rise, the greater the probability of acute pancreatitis.

Decreased in:

• Pancreatic insufficiency
• Cystic fibrosis
• Severe liver disease
• Pancreatectomy
• Usually normal or low in chronic pancreatitis