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
DOI: 10.22514/sv.2021.133 Vol.18,Issue 3,May 2022 pp.163-165
Submitted: 12 March 2021 Accepted: 07 April 2021
Published: 08 May 2022
*Corresponding Author(s): Duk Ho Kim E-mail: email@example.com
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
Duk Ho Kim,Soon-Hyun Kang. Implications of a blood sample with an extremely high lipid content in the emergency department: a case report. Signa Vitae. 2022. 18(3);163-165.
 Sen Gupta P, Sharma M, Timms P. Laboratory samples deemed ‘unsuitable for analysis’ can be diagnostically useful. Clinical Medicine. 2013; 13: 309–311.
 Kroll MH, Elin RJ. Interference with clinical laboratory analyses. Clinical Chemistry. 1994; 40: 1996–2005.
 Nikolac N. Lipemia: causes, interference mechanisms, detection and management. Biochemia Medica. 2014; 24: 57–67.
 Gan S, Edwards A, Symonds C, Beck P. Hypertriglyceridemia-induced pancreatitis: a case-based review. World Journal of Gastroenterology. 2006; 12: 7197–7202.
 Sezgin O, Özdoğan O, Yaraş S, Üçbilek E, Altıntaş E. Evaluation of hypertriglyceridemia-induced acute pancreatitis: a single tertiary care unit experience from Turkey. Turkish Journal of Gastroenterology. 2019; 30: 271–277.
 Zhang X, Li F, Zhen Y, Li A, Fang Y. Clinical study of 224 patients with hypertriglyceridemia pancreatitis. Chinese Medical Journal. 2015; 128: 2045–2049.
 Tan HLE, McDonald G, Payne A, Yu W, Ismadi Z, Tran H, et al. Incidence and management of hypertriglyceridemia-associated acute pancreatitis: a prospective case series in a single Australian tertiary centre. Journal of clinical medicine. 2020; 9: 3954.
 Carr RA, Rejowski BJ, Cote GA, Pitt HA, Zyromski NJ. Systematic review of hypertriglyceridemia-induced acute pancreatitis: a more virulent etiology? Pancreatology. 2016; 16: 469–476.
 Charlesworth A, Steger A, Crook MA. Acute pancreatitis associated with severe hypertriglyceridaemia; a retrospective cohort study. International Journal of Surgery. 2015; 23: 23–27.
 Mainali S, Davis SR, Krasowski MD. Frequency and causes of lipemia interference of clinical chemistry laboratory tests. Practical Laboratory Medicine. 2017; 8: 1–9.
 Andrade NNN, Oliveira MV, Souza CL. Procedures to minimize interference of hypertriglyceridemia in laboratory exams of lipemic samples in acute pancreatitis: a case report. Jornal Brasileiro de Patologia e Medicina Laboratorial. 2016; 52: 103–106.
Vol., Issue , Invalid dateTable of contents
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus: CiteScore 0.5(2021) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.