Poster - #2022SPHU-34 - Keywords: Pancreatitis

The role of extremely elevated (>10,000 U/L) serum lipase enzyme in acute pancreatitis

Ali Khalifa, M.D.1, Augustine Tawadros, M.D.2, Sowjanya Kanna, M.D.2
From the Department of Internal Medicine1 and Division of Gastroenterology2, Rutgers Medical School of Robert Wood Johnson, Saint Peter's University Hospital Campus, New Brunswick, New Jersey. C-31

ABSTRACT:
A 36-year-old man with history of isolated hypercholesterolemia and alcoholism presented for acute epigastric pain. Laboratory work showed normal serum calcium, triglycerides, liver function tests, yet serum lipase was >10,000U/L. Ultrasound, contrast-computed tomography, and magnetic resonance cholangiopancreatography confirmed the diagnosis of acute pancreatitis with no evidence of gallstones. Hereditary pancreatitis workup was negative. Hence, we here present a rare case of acute alcoholic pancreatitis in context of extremely elevated serum lipase. We therefore conclude that despite the available data suggesting that high level of lipases are almost always second to gallstone or hereditary etiology, clinicians should be cognizant about alcohol as a possible etiology, especially when it’s the first acute pancreatitis attack.