Page 71 - JCBP-2-1

Journal of Clinical and

Basic Psychosomatics

CASE REPORT
Abnormal elevation of serum amylase in a

patient with acute depression in a state of
sub-stupor: A case report

Qiang Wang , Peng Zhao , Qiuyun Cao , Yi Li , Rong Lu , and Zhijian Yao *
1
2
3
2
1
1
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

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 3 day. Following
rd
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
*Corresponding author:
Zhijian Yao linked to his psychiatric symptoms. Based on this case, we speculate that besides
(yaozhijian@aliyun.com) physical illness, the stupor symptoms observed in patients with depression may
also lead to elevated serum amylase. Therefore, clinicians must prioritize addressing
Citation: Wang Q, Zhao P, Cao Q,
et al., 2024, Abnormal elevation psychiatric symptoms when encountering such situations.
of serum amylase in a patient with
acute depression in a state of
sub-stupor: A case report. J Clin Keywords: Serum amylase; Depression; Psychiatric symptoms; Sub-stupor state; Physical
Basic Psychosom, 2(1): 0550. illness; Case report
https://doi.org/10.36922/jcbp.0550
Received: April 18, 2023
Accepted: July 18, 2023
1. Introduction
Published Online: August 11, 2023
Serum amylase could be classified into two main types in almost equal proportions:
Copyright: © 2023 Author(s).
This is an Open-Access article pancreatic-type, primarily secreted by the pancreas, and salivary-type, which is the
distributed under the terms of the predominant fraction in normal serum and is derived from salivary gland tissue and
Creative Commons Attribution other organs [1,2] . Clinically, elevated serum amylase level is commonly associated with
License, permitting distribution,
and reproduction in any medium, various abnormal medical conditions, including pancreatitis, pneumonia, shock, and
provided the original work is post-cardiac surgery [1,3] . In addition, cases of abnormally elevated serum amylase have
properly cited. been observed in the psychiatric department. For instance, mirtazapine causes acute
[4]
Publisher’s Note: AccScience pancreatitis and subsequent elevation of amylase level . Moreover, patients taking
Publishing remains neutral with lithium may also experience elevated serum amylase with an unknown mechanism .
[5]
regard to jurisdictional claims in
published maps and institutional Studies suggest that even in the absence of pancreatic injury, abnormal elevation of
[6]
affiliations. serum amylase should be carefully monitored due to the increased risk of death .
Volume 2 Issue 1 (2024) 1 https://doi.org/10.36922/jcbp.0550