To the Editor.—
This letter is written in regard to the article by Fallat et al, "Suppression of Amylase Activity by Hypertriglyceridemia" (225:1331, 1973). The authors investigated the etiology of normal amylase values frequently recorded in patients with hyperlipemic pancreatitis.1 The thesis developed is that patients with hyperlipemic pancreatitis do, in fact, have elevated serum amylase levels and that "serial dilutions of serum with saline solution allow correction to 'actual' amylase in hyperlipemic serum."knowledge of a corrected amylase level, coupled with the clinical course, would help to confirm a primary diagnosis of acute hyperlipemic pancreatitis, and allow prompt surgical intervention to be delayed or deferred in favor of intensive medical therapy.In view of the far-reaching implications of these conclusions, we feel compelled to express our skepticism, supported by our experience with a patient with hyperlipemic pancreatitis. In the saline dilution studies described, the authors do not allow
Mishkin S, O'Hashi J, Schneider P. Amylase Activity in Hyperlipemic Pancreatitis. JAMA. 1974;228(5):568–569. doi:10.1001/jama.1974.03230300016015
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