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Implications of a blood sample with an extremely high lipid content in the emergency department: a case report

  • Duk Ho Kim1
  • Soon-Hyun Kang2

1Department of Emergency Medicine, Eulji University, School of Medicine, 01830 Seoul, Republic of Korea

2Division of Medical Oncology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 03722 Seoul, Republic of Korea

DOI: 10.22514/sv.2021.133

Submitted: 12 March 2021 Accepted: 07 April 2021

Online publish date: 09 August 2021

*Corresponding Author(s): Duk Ho Kim E-mail: 20180114@eulji.ac.kr

Abstract

Non-measurable blood test results are difficult to diagnose in emergency departments (EDs), especially since most emergency blood tests are performed in these settings. In this case, we present a 33-year-old male patient who consulted to the ED with worsening left flank pain and vomiting that started 6 hours before presentation. A comprehensive metabolic panel was not reported, as the test sample was high in lipids. On non-enhanced abdomen/pelvic computed tomography (CT), fluid collection around the pancreatic tail, without necrotic changes of parenchymal tissue suggested the possibility of acute pancreatitis. Blood investigations revealed a marked increase in triglyceride levels (8001 mg/dL). The patient was then admitted to the intensive care unit for severe hypertriglyceridemia-induced acute pancreatitis (HTG-induced AP), and later discharged home after treatment for seven days with insulin therapy and routine medication for hyperlipidemia. We present a case in which the laboratory comments of “not available for analysis” with regard to a blood sample have diagnostic implications.


Keywords

Lipemic sample; Hypertriglyceridemia; Acute pancreatitis


Cite and Share

Duk Ho Kim,Soon-Hyun Kang. Implications of a blood sample with an extremely high lipid content in the emergency department: a case report. Signa Vitae. 2021.doi:10.22514/sv.2021.133.

References

[1] Sen Gupta P, Sharma M, Timms P. Laboratory samples deemed ‘unsuitable for analysis’ can be diagnostically useful. Clinical Medicine. 2013; 13: 309–311.

[2] Kroll MH, Elin RJ. Interference with clinical laboratory analyses. Clinical Chemistry. 1994; 40: 1996–2005.

[3] Nikolac N. Lipemia: causes, interference mechanisms, detection and management. Biochemia Medica. 2014; 24: 57–67.

[4] Gan S, Edwards A, Symonds C, Beck P. Hypertriglyceridemia-induced pancreatitis: a case-based review. World Journal of Gastroenterology. 2006; 12: 7197–7202.

[5] Sezgin O, Özdoğan O, Yaraş S, Üçbilek E, Altıntaş E. Evaluation of hypertriglyceridemia-induced acute pancreatitis: a single tertiary care unit experience from Turkey. Turkish Journal of Gastroenterology. 2019; 30: 271–277.

[6] Zhang X, Li F, Zhen Y, Li A, Fang Y. Clinical study of 224 patients with hypertriglyceridemia pancreatitis. Chinese Medical Journal. 2015; 128: 2045–2049.

[7] Tan HLE, McDonald G, Payne A, Yu W, Ismadi Z, Tran H, et al. Incidence and management of hypertriglyceridemia-associated acute pancreatitis: a prospective case series in a single Australian tertiary centre. Journal of clinical medicine. 2020; 9: 3954.

[8] Carr RA, Rejowski BJ, Cote GA, Pitt HA, Zyromski NJ. Systematic review of hypertriglyceridemia-induced acute pancreatitis: a more virulent etiology? Pancreatology. 2016; 16: 469–476.

[9] Charlesworth A, Steger A, Crook MA. Acute pancreatitis associated with severe hypertriglyceridaemia; a retrospective cohort study. International Journal of Surgery. 2015; 23: 23–27.

[10] Mainali S, Davis SR, Krasowski MD. Frequency and causes of lipemia interference of clinical chemistry laboratory tests. Practical Laboratory Medicine. 2017; 8: 1–9.

[11] Andrade NNN, Oliveira MV, Souza CL. Procedures to minimize interference of hypertriglyceridemia in laboratory exams of lipemic samples in acute pancreatitis: a case report. Jornal Brasileiro de Patologia e Medicina Laboratorial. 2016; 52: 103–106.


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