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Abnormal elevation of serum amylase in a patient with acute depression in a state of sub-stupor: A case report
Qiang Wang1 ,
Peng Zhao1 ,
Qiuyun Cao1 ,
Yi Li2 ,
Rong Lu2 ,
Zhijian Yao3*
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1
Department of Medical Psychology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Medical School, Nanjing University, Nanjing,
China
2
Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing,
China
3
Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing,
China
Submitted: 18 April 2023 | Accepted: 18 July 2023 | Published: 11 August 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract
Serum amylase predominantly comprises pancreatic and salivary amylases and its elevation is commonly associated with pancreatitis and other physical diseases. This case report presents a 63-year-old male with first-episode depression who exhibited abnormally elevated serum amylase. Shortly after admission, the patient entered a sub-stupor state. The patient developed symptoms such as high fever and excessive sweating on the second night. In addition, myocardial damage was observed. The serum amylase was found to be elevated in the morning on the 3rd day. Following symptomatic and supportive treatments, the patient’s serum amylase level gradually dropped to drop to normal over approximately 2 weeks. On careful analysis of the patient’s medical condition, we suspect the increased serum amylase level may be linked to his psychiatric symptoms. Based on this case, we speculate that besides physical illness, the stupor symptoms observed in patients with depression may also lead to elevated serum amylase. Therefore, clinicians must prioritize addressing psychiatric symptoms when encountering such situations.
Keywords
Serum amylase
Depression
Psychiatric symptoms
Sub-stupor state
Physical illness
Case report
Funding
National Natural Science Foundation of China
Jiangsu Provincial key research and development program
Jiangsu Provincial Medical Innovation Team of the Project of Invigorating Health Care through Science, Technology and Education
Key Project supported by Medical Science and Technology development Foundation, Jiangsu Commission of Health
National Key R & D Plan
Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University
References
- Nakajima K, 2015, High serum amylase levels may reflect a wide spectrum of health benefits. Clin Chem Lab Med, 53: e67–e68. https://doi.org/10.1515/cclm-2014-1120
- Salt WB 2nd, Schenker S, 1976, Amylase--its clinical significance: A review of the literature. Medicine (Baltimore), 55: 269–289. https://doi.org/10.1097/00005792-197607000-00001
- Muniraj T, Dang S, Pitchumoni CS, 2015, Pancreatitis or not?--Elevated lipase and amylase in ICU patients. J Crit Care, 30: 1370–1375. https://doi.org/10.1016/j.jcrc.2015.08.020
- Chen JL, Spinowitz N, Karwa M, 2003, Hypertriglyceridemia, acute pancreatitis, and diabetic ketoacidosis possibly associated with mirtazapine therapy: A case report. Pharmacotherapy, 23: 940–944. https://doi.org/10.1592/phco.23.7.940.32725
- Tham A, Johnson L, Mathé AA, 1990, Serum amylase in patients treated with lithium. Psychopharmacology (Berl), 102: 417–418. https://doi.org/10.1007/bf02244114
- Malinoski DJ, Hadjizacharia P, Salim A, et al., 2009, Elevated serum pancreatic enzyme levels after hemorrhagic shock predict organ failure and death. J Trauma, 67: 445–449. https://doi.org/10.1097/ta.0b013e3181b5dc11
- Kumar P, Ghosh A, Tandon V, et al., 2016, Gullo’s syndrome: A case report. J Clin Diagn Res, 10: OD21–OD22. https://doi.org/10.7860/jcdr/2016/17038.7285
- Li T, Nagayama N, Kawabe Y, et al., 1989, Hyperamylasemia in acute exacerbation in patients with chronic respiratory failure. Nihon Kyobu Shikkan Gakkai Zasshi, 27: 488–496.
- Piton G, Barbot O, Manzon C, et al., 2010, Acute ischemic pancreatitis following cardiac arrest: A case report. JOP, 11: 456–459. https://doi.org/10.6092/1590-8577/3434
- Hauser G, Blažević I, Salkić N, et al., 2017, Diclofenac sodium versus ceftazidime for preventing pancreatitis after endoscopic retrograde cholangiopancreatography: A prospective, randomized, controlled trial. Surg Endosc, 31: 602–610. https://doi.org/10.1007/s00464-016-5004-9
- Hu TM, Subeq YM, Yang FL, et al., 2013, The use of a selective serotonin reuptake inhibitor decreases heavy alcohol exposure-induced inflammatory response and tissue damage in rats. J Psychopharmacol, 27: 940–946. https://doi.org/10.1177/0269881113494938
- He Y, Fang W, Li Z, et al., 2022, Analysis of the clinical characteristics of olanzapine-induced acute pancreatitis. Ther Adv Psychopharmacol, 12. https://doi.org/10.1177/20451253221079971
- Shitobi Y, Akiyoshi J, Tanaka Y, et al., 2010, Elevated salivary α-amylase and cortisol levels in unremitted and remitted depressed patients. Int J Psychiatry Clin Pract, 14: 268–273. https://doi.org/10.3109/13651501.2010.500737
- Bauduin SE, van Noorden MS, van der Werff SJ, et al., 2018, Elevated salivary alpha-amylase levels at awakening in patients with depression. Psychoneuroendocrinology, 97: 69–77. https://doi.org/10.1016/j.psyneuen.2018.07.001
- Nater UM, Rohleder N, 2009, Salivary alpha-amylase as a non-invasive biomarker for the sympathetic nervous system: Current state of research. Psychoneuroendocrinology, 34: 486–496. https://doi.org/10.1016/j.psyneuen.2009.01.014
- Nater UM, Rohleder N, Gaab J, et al., 2005, Human salivary alpha-amylase reactivity in a psychosocial stress paradigm. Int J Psychophysiol, 55: 333–342. https://doi.org/10.1016/j.ijpsycho.2004.09.009
- Ieda M, Miyaoka T, Kawano K, et al., 2012, May salivary alpha-amylase level be a useful tool for assessment of the severity of schizophrenia and evaluation of therapy? A case report. Case Rep Psychiatry, 2012: 747104. https://doi.org/10.1155/2012/747104
- Scheutzel P, Gerlach U, 1991, Alpha-amylase isoenzymes in serum and saliva of patients with anorexia and bulimia nervosa. Z Gastroenterol, 29: 339–345.
Conflict of interest
The authors declare that they have no conflicts of interest.