Pitfall of Amylase in Acute Pancreatitis

Q: Markedly elevated triglyceride level in acute pancreatitis can falsely (select one)

 A) Increase the amylase level in laboratory
 B) normalize the amylase level in laboratory


 Answer: B

Once serum triglyceride levels go above 500 mg/dL, it may falsely normalize the amylase level. This is due to an interference of the calorimetric reading. In such scenarios, the lipase level would be more reliable as an indicator of the severity of acute pancreatitis.

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References:

 1. Howard JM, Reed J. Pseudohyponatremia in acute hyperlipemic pancreatitis. A potential pitfall in therapy. Arch Surg 1985; 120:1053.

 2. Fallat RW, Vester JW, Glueck CJ. Suppression of amylase activity by hypertriglyceridemia. JAMA 1973; 225:1331.