Diagnostic difficulties with a lipaemic blood sample

Lipaemia: Causes, consequences and solutions

“…To reduce the effect of lipaemia on sodium measurement a direct method where there is no dilutional step can be employed which will prevent a spuriously low result being produced. To reduce the effect of lipaemia on serum amylase it may be helpful to measure the amylase:creatinine clearance ratio in urine to provide evidence to support a diagnosis of acute pancreatitis and this may be a more sensitive indicator of acute pancreatitis [4][5][6][7]. Serum lipase activity is also less likely to be subject to interference by lipaemia and may be a useful alternative to serum amylase.…”

“…The finding of an elevated plasma amylase approximately three to four times the upper limit of normal in combination with clinical features characteristic of acute pancreatitis such as abdominal pain and vomiting can support the diagnosis. A normal plasma amylase activity does not exclude the diagnosis of acute pancreatitis as this may be secondary to hypertriglyceridaemia which can produce a falsely low plasma amylase [4][5][6][7]. This is an important clinical and medico-legal issue as a "spuriously" low or normal plasma amylase may lead clinicians to miss the diagnosis of acute pancreatitis; a potentially fatal condition.…”