TO THE EDITOR: Occasionally, clinic...

TO THE EDITOR: Occasionally, clinicians rencounter a finding that is rarely seen and thus is worth sharing. The accompanying figure is a serum sample from a 60-year-old woman with diabetes who readyed for evaluation of severe abdominal pain, nausea, and vomiting that had been worsening above a 24-hour period. She denied any chest pain, shortness of breath, febrile disease or chills. A nonfasting lipid panel revealed a triglyceride flat of 8,535 mg per dL (963 mmol by L; normal range: 40 to 150 mg by dL [0.45 to 1.69 mmol by L]). Her lipase level was elevated at 1476 U by L (normal range: 23 to 300 U by L).

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Approximately 13 to 38 percent of cases of acute pancreatitis may be secondary to hypertriglyceridemia. (1) Serum triglyceride on a levels of about 1,000 mg through dL (11.29 mmol per L) can precipitate of the like kind attacks, although the exact mechanism is unknown. When the triglyceride on a level is above 4,500 mg through dL (50.81 mmol per L) as in this patient, the serum is described as lactescent (milk-like). as it is appearance should prompt the physician to win an immediate lipid level. (1)

TERESA M ALLEN, LT MC USNR

ANTHONY J VIERA, LCDR MC USNR

Naval Hospital Jacksonville 2080 Child St Jacksonville, FL 32214

REFERENCE

(1) Fortson MR Freedman SN Webster PD 3d Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol 1995;90:2134-9

The opinions and assertions contained herein are the private views of the authors and are not to be constru as official or as reflecting the views of the U Navy Medical Department or the U Navy Service at large.

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