Pancreatitis may occur with a normal amylase concentration in hypertriglyceridaemia

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7067.1265 (Published 16 November 1996) Cite this as: BMJ 1996;313:1265
  1. Pankaj Sharma,
  2. Sharon Lim,
  3. David James,
  4. Robin T Orchard,
  5. Morag Horne,
  6. Carl A Seymour
  1. Medical registrar Senior house officer Senior house officer Consultant physician Department of Medicine, St Helier's NHS Trust, Carshalton, Surrey SM5 1AA
  2. Senior registrar Professor Department of Clinical Biochemistry, St George's Hospital Medical School, London SW17 0RE

    EDITOR,—Johan Hedstrom and colleagues report that the trypsin 2-(alpha)1 antitrypsin complex is a diagnostic marker of pancreatitis.1 This reminds us of a diagnostic problem that arose when only the serum amylase concentration was considered in a patient with severe abdominal pain.

    A 39 year old Muslim man presented with severe generalised abdominal pain. The surgical team concluded that his amylase concentration (57 IU/l; normal 0–90 IU/l) excluded acute pancreatitis. He had non-insulin dependent diabetes, smoked 20 cigarettes a day, and rarely drank alcohol. He had bilateral supraorbital xanthelasmas …

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