Implications of a blood sample with an extremely high lipid content in the emergency department: a case report
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
Submitted: 12 March 2021 Accepted: 07 April 2021
Online publish date: 09 August 2021
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.
Lipemic sample; Hypertriglyceridemia; Acute pancreatitis
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