serum amylase in hypertriglyceridemia-induced pancreatitis

Q: Why serum amylase may stay normal in hypertriglyceridemia-induced pancreatitis? 

 Answer: Serum amylase level comes out normal in hypertriglyceridemia-induced pancreatitis due to a circulatory inhibitor which interferes with the assay. This is usually a case when plasma triglyceride levels are higher than 500 mg/dL. 

Experienced laboratory personnel can recognize lactescent plasma and can provide true serum amylase value by serial dilution techniques. 

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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.

3. Wong EC, Butch AW, Rosenblum]L. The clinical chemistry laboratory and acute pancreatitis. Clin Chem 1993;39:234-43.