Patients with clinical acute pancreatitis or abdominal crises possibly indicating surgery, accompanied by lactescent plasma and "normal" serum amylase values, pose a therapeutic dilemma of medical supportive therapy vs prompt surgical intervention. Plasma triglyceride levels in the 500 to 6,000 mg/100 ml range (with grossly turbid plasma) interfere in vitro with determination of amylase activity. In three patients with clinical pancreatitis (normal undiluted serum amylase levels) and lactescent plasma with type V hyperlipoproteinemia, serum amylase level was shown to be elevated after correction for dilution. Serial dilutions of serum with saline solution allow correction to "actual" amylase in hyperlipemic serum, apparently by reducing in vitro interference caused by elevated triglyceride levels.
Fallat RW, Vester JW, Glueck CJ. Suppression of Amylase Activity by Hypertriglyceridemia. JAMA. 1973;225(11):1331–1334. doi:10.1001/jama.1973.03220390031007