Enhancement of the Amylase-Creatinine Clearance Ratio in Disorders Other Than Acute Pancreatitis

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Abstract
The ratio of amylase to creatinine clearance was determined during 10 episodes of ketoacidosis occurring in nine patients with diabetes mellitus and in six patients with burns. Similar determinations were made for the purpose of comparison in 10 diabetic outpatients managed with insulin or oral hypoglycemic agents and 12 normal subjects. The ratios in the ketoacidotic diabetic patients were significantly greater than those in the normal subjects (p < 0.001) as well as those in the nonacidotic diabetic patients (p < 0.001). The burned patients also displayed values that were significantly greater than those in the normal subjects, but to a lesser degree (p < 0.05). Serum amylase activity was slightly increased during three episodes of ketoacidosis in two of the diabetic patients with this complication and was markedly elevated in one of the burned patients. These observations indicate that increased ratios of amylase to creatinine clearance may occur in situations other than acute pancreatitis, both with and without elevated serum amylase activity (N Engl J Med 292:329–332,1975)