Combating Lipemia in Severe Hypertriglyceridemia Pancreatitis: Dilution and Centrifugal Tactics

Severe hypertriglyceridemia (HTG) is a critical risk factor for acute pancreatitis. Lipemic interference in laboratory testing complicates diagnosis and delays clinical intervention. This case highlights strategies to mitigate lipemia-induced analytical errors.

A 42-year-old male presented with severe abdominal pain and markedly elevated triglycerides (> 21.94 mmol/L). Lipemia interference was addressed via 1) 10-fold dilution for rapid lipid profiling and 2) high-speed centrifugation (15,000 rpm, 20 minutes) with repeated processing of the subnatant.

Dilution provided preliminary lipid results within 2.5 hours, revealing extreme hypertriglyceridemia (77.72 mmol/L), prompting plasma exchange. Centrifugation corrected electrolyte and protein measurements (e.g., sodium: 128 - 137 mmol/L; total protein: 84.2 - 62.8 g/L).

Dilution and centrifugation are effective for rapid reporting and accurate analysis of lipemic samples. Standardized protocols for lipemia management are essential for timely clinical decision-making.