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Lipase Elevation Common in DKA, Not Indication of Pancreatitis

doi: 10.1097/01.EEM.0000731776.29343.8b


    Elevations of serum lipase are not rare in DKA. Its clinical presentation includes abdominal pain, nausea, and vomiting, and detection of hyperlipasemia can lead to an erroneous overdiagnosis of pancreatitis. (J Emerg Med. 2020 59[3]:371; J Crit Care. 2015;30[6]:1370; Am J Gastroenterol. 2000;95[11]:3123; Pediatr Crit Care Med. 2008;9[4]:418.)

    Serum lipase is often elevated in patients with DKA who do not have any other clinical or radiological evidence of pancreatitis.

    A study of 135 adults with DKA found nonspecific elevations of lipase in 24 percent of cases. Elevations more than three times normal were commonly seen. (Am J Gastroenterol. 2000;95[11]:3123.) Lipase levels are often elevated in children with DKA and are rarely related to pancreatitis. A prospective study found lipase elevated in 31 percent of 67 children with DKA. (Pediatr Crit Care Med. 2008;9[4]:418.)

    The elevations in serum lipase were not associated with abdominal pain and rapidly returned to baseline after DKA treatment in most patients. (Pediatr Crit Care Med. 2008;9[4]:418.) The mechanisms for hyperlipasemia in DKA not associated with pancreatitis are not well understood.

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