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Elevated Lipase in an Infant with Altered Mental Status
Iván González1, Stephen Roper1
1Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri.
Laboratory Medicine
|December 14, 2019
Summary
Elevated lipase and amylase levels can indicate acute pancreatitis. However, transient elevations may be caused by other factors, such as medication, prompting further investigation.
Area of Science:
- Biochemistry
- Clinical Diagnostics
- Gastroenterology
Background:
- Pancreatic enzymes lipase and amylase are crucial for fat and polysaccharide digestion.
- Elevated levels are commonly used in emergency departments to diagnose acute pancreatitis.
- Normal acute pancreatitis cases exhibit predictable enzyme kinetics: a rapid rise, peak at 24 hours, and gradual decline over 7-14 days.
Observation:
- This case report details an incidental finding of elevated lipase in an infant.
- The patient was an African American baby girl who had ingested oxycodone.
- This incidental discovery led to further laboratory and radiological investigations.
Findings:
- Transient elevations in pancreatic enzymes can occur due to factors other than acute pancreatitis.
- Exogenous substances, like oxycodone, can influence gastrointestinal motility and enzyme levels.
- The patient's elevated lipase was linked to oxycodone ingestion, not pancreatitis.
Implications:
- Clinicians should consider alternative causes for transient pancreatic enzyme elevations.
- Awareness of drug-induced effects on gastrointestinal motility is crucial.
- Recognizing exogenous influences can prevent unnecessary diagnostic work-ups and associated costs.
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