Persistent Asymptomatic Pancreatic Hyperenzymemia or Gullo's Syndrome: A Case Report.

Elevated pancreatic enzymes usually point towards pancreatic disease. In the absence of supporting clinical and imaging findings, interpretation of such elevation is challenging. We report the case of a 53-year-old man who presented with incidentally detected asymptomatic elevation of serum amylase and lipase. He was then investigated extensively without yielding remarkable laboratory or imaging findings. He was closely followed up for two years to determine the benign course of the syndrome. He remained asymptomatic without any additional imaging findings. A diagnosis of benign pancreatic hyperenzymemia or Gullo's syndrome was made. Benign pancreatic hyperenzymemia is a syndrome characterized by persistently elevated pancreatic enzymes in the absence of any underlying pancreatic disease (amylase ranged 236-520 U/L and lipase 257-956 U/L over 28 months, and two endoscopic ultrasonography (EUS) examinations (24 months apart) showed stable non-diagnostic lobularity without honeycombing). It is a diagnosis of exclusion. Treatment is reassurance and avoidance of costly re-investigations.