Page 73 - JCBP-2-1

Journal of Clinical and
Basic Psychosomatics Elevated serum amylase in MDD patient

Table 1. Laboratory results at admission and during follow‑up
Biochemical indicators Normal range Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 8 Day 16 Day 23
06:00 09:40 14:40
Complete blood count
White blood cells 4–10×10 /L 9.99 14.96 16.18 - - 10.88 8.68 8.82 9.1 10.11 7.35
9
Percentage of neutrophils 50–65% 75.2 76.4 79.9 - - 84.1 80.9 81.8 68.8 66 61.2
Coagulation
D dimer 0–243 ng/mL - 778 - - - - - - - - -
Antithrombin III 83–128% - 149 - - - - - - - - -
Fibrin degradation product 0–5 ug/mL - 6.5 - - - - - - - - -
Myocardial function
Creatine kinase-MB 0–3.7 ng/mL - 22.1 63.1 73.3 60.2 2.01 17.4 - 5.6 - -
Myoglobin 0–73 ng/mL - >1000 >1000 >1000 >1000 517.44 491.37 - 117.37 - -
Troponin I 0–0.06 ng/mL - 0.15 1.02 0.69 0.63 0.18 0.1 - 0.03 - -
Brain natriuretic peptide 0–100 pg/mL - 64 73 120 - - - - - - -
Liver function
Alanine aminotransferase 5–40 U/L 50 54 - 60 - 70 73 75 50 31 21
Aspartate aminotransferase 5–40 U/L 50 68 - 120 - 179 161 117 58 21 21
Blood culture
Left Negative - Normal - - - - - - - - -
Right Negative - Normal - - - - - - - - -
Other tests
C-reactive protein <5 mg/L Normal Normal - - - 47.12 33.27 12.33 - - -
High-sensitivity <0.5 mg/L Normal Normal - - - >5 >5 >5 - - -
C-reactive protein
Lactate dehydrogenase 110–240 U/L - - - 458 - - - - 341 234 164
Creatine kinase 25–200 U/L - - - 3614 - - - - 524 60 -
Serum amylase 0–100 U/L - - - 884 666 283 235 317 152 73 -
Serum calcium 2.15–2.57 mmol/L 2.55 2.61 - - - 2.29 2.3 2.27 - - -
Procalcitonin <0.5 ng/mL - Normal - - - - - - - - -

frame, the 3 day may be a critical time point. It is possible function and increased serum amylase level. Previous
rd
that the serum amylase had already increased before cases have reported that cardiac arrest or hemorrhagic
then, but it gradually decreased after the resolution of shock can cause pancreatitis and elevated serum amylase
pneumonia on the 3 day. There has been a reported case level [6,9] . However, in this patient, the heart function was
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of elevated serum amylase in association with pneumonia, not impaired, and CT did not reveal abnormalities in the
identified as benign pancreatic hyperenzymemia or Gullo’s pancreas. As a result, myocardial injury cannot provide a
syndrome, where the serum amylase remained high even in satisfactory explanation for the elevated serum amylase
the following year . Some scholars have suggested that the level.
[7]
increase in serum amylase is observed only when there are The patient, in this case, had been on multiple
lung infections and respiratory failure simultaneously . medications before admission (Table 2). Regarding
[8]
However, in the present case, the patient did not meet medication, the instruction manual for cefprozil did
the criteria of having conditions concurrently, making it not mention an association with pancreatitis or amylase
unlikely that pneumonia caused the increase in amylase elevation, and no relevant information was found when
level. searching for the terms “cefprozil amylase” on online
Another possibility is that myocardial infarction affects resources. Ambroxol has a similar profile to cefprozil
the blood supply of the pancreas, resulting in impaired in this regard. On the other hand, ceftazidime has been

Volume 2 Issue 1 (2024) 3 https://doi.org/10.36922/jcbp.0550