Macroamylasemia or Cholecystitis: What is the Culprit of Abdominal Pain?

Question: A 75-year-old man was hospitalized in the Gastroenterology Department with a 14-day history of intermittent right upper quadrant abdominal pain and low-grade fever, without chills and other systemic symptoms. He had a past medical history of polymyalgia rheumatica (PMR), benign prostatic hyperplasia, and hypertension. The patient had history of methylprednisolone and methotrexate use, which was administered for 2 years, and he had no history of smoking or alcohol consumption. On hospital admission, the patient showed stable vital signs and his body temperature was 37.7°C.