Serum Lipids in Acute Pancreatitis

Abstract

Lactescence of the serum in acute pancreatitis, supposedly a rare manifestation of this disorder, was first reported in 1865.1 More recently, the increased incidence of relapsing pancreatitis in persons with idiopathic hyperlipemia has been stressed.2 6 The occurrence of elevated serum lipid levels in experimental pancreatitis in the dog was reported in 1929.7 Systematic studies performed in this laboratory demonstrated elevations of all serum lipid fractions in experimental acute pancreatitis in rabbits and dogs.8 It therefore appears that transient lipemia may accompany acute pancreatitis and that acute pancreatitis may be a complication of idiopathic hyperlipemia. Diabetic acidosis, if present, may contribute to the elevation of circulating lipoids. 9 . 10 It seemed profitable to review the records of patients with acute pancreatitis seen at the Mount Sinai Hospital during the past 22 years, with special emphasis on those in whom serum lipid determinations were performed. A smaller group of six patients, observed during the past five years, in whom serial determinations of serum lipids had been performed, are presented in detail. Serum cholesterol was determined by the Sperry-Schoenheimer method, phospholipids by the Sperry modification of the FiskeSubbaRow method, and total lipids by the Bloor method. Serum amylase was determined by the method of Somogyi (normal range 80 to 180 units per 100 ml). Selection of pat1·ents. One hundred and three patients, hospitalized between the years 1936 and 1957, were selected for review. The diagnosis of acute pancreatitis was established in 65 patients; by surgical laparotomy in 47 persons and by autopsy in 18 (proved cases). The diagnosis in the remaining 38 patients was based on clinical, laboratory, and roentgenologic findings (presumptive cases). Patients with chronic