Q: In which condition almost quarter (25%) of patients may have falsely positive elevated lipase level?

 

Answer: DKA (Diabetic Keto-acidosis)

In DKA nonspecific elevations of amylase and lipase occurs up to 25% of cases.

• Amylase elevation is correlated with pH and serum osmolality,
• Lipase elevation is correlated with serum osmolality alone.

Diagnosis of Acute Pancreatits based soley on elevated amylase or lipase, even>3 times normal, is  said to be not justifiable.



Reference:

Yadav D, Nair S, Norkus EP, Pitchumoni CS - Nonspecific hyperamylasemia and hyperlipasemia in diabetic ketoacidosis: incidence and correlation with biochemical abnormalities.- Am J Gastroenterol. 2000;95(11):3123.