scholarly journals Significantly Elevated Serum Lipase in Pregnancy with Nausea and Vomiting: Acute Pancreatitis or Hyperemesis Gravidarum?

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Amanda Johnson ◽  
Bethany Cluskey ◽  
Nina Hooshvar ◽  
Daphne Tice ◽  
Courtney Devin ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Biochemical Marker ◽  
Hyperemesis Gravidarum ◽  
Elevated Serum ◽  
Clinical Findings ◽  
Nausea And Vomiting ◽  
Imaging Studies ◽  
Severe Nausea ◽  
Serum Lipase ◽  
Severe Manifestation

Hyperemesis gravidarum is a severe manifestation of nausea and vomiting of pregnancy and it is associated with weight loss and metabolic abnormalities. It is known that abnormal laboratory values, including mildly elevated serum lipase level, could be associated with hyperemesis gravidarum. However, in this case report details of two women with hyperemesis gravidarum but with significantly elevated serum lipase levels were discussed. These patients presented with severe nausea and vomiting but without abdominal pain. They were found to have severely elevated lipase levels over 1,000 units/liter. In the absence of other findings of pancreatitis, they were treated with conservative measures for hyperemesis gravidarum, with eventual resolution to normal lipase levels. Although significantly elevated lipase level in pregnant patients with nausea and vomiting is a concern for acute pancreatitis, these two cases of significantly elevated serum lipase without other clinical findings of pancreatitis led to this report that serum lipase could be quite elevated in hyperemesis gravidarum and that it might not be an accurate biochemical marker for acute pancreatitis. Imaging studies are thus necessary to establish the diagnosis of acute pancreatitis.

scholarly journals Study of serum lipase level in pregnant woman presenting with nausea and vomiting

2019 ◽  
Vol 9 (1) ◽  
pp. 1480-1484
Author(s):  
Arun Dhungana ◽  
Pratigyan Gautam ◽  
Rosina Manandhar ◽  
Chanda Karki
Keyword(s):  
Serum Amylase ◽  
Hyperemesis Gravidarum ◽  
Serum Glucose ◽  
Nausea And Vomiting ◽  
Electrolyte Imbalance ◽  
Normal Range ◽  
Serum Lipase ◽  
Biochemical Basis ◽  
Glucose Levels ◽  
Serum Amylase Activity

Background: Hyperemesis gravidarum is a complex condition characterized by excessive nausea and vomiting during pregnancy. It presents with various symptoms which include disturbed nutrition, electrolyte imbalance, ketosis and extreme weight loss. The objective of this study is to compare serum lipase, amylase and glucose in Hyperemesis gravidarum with non-pregnant women. Materials and methods: A total of 100 subjects among which 50 were nonpregnant women as controls and 50 were women with hyperemesis gravidarum as cases were enrolled in the study. Serum lipase, amylase and glucose levels were estimated in all the subjects. Results: The levels of mean serum lipase were lesser in cases (23.55 ± 4.91U/L) compared to that in controls (25.45 ± 5.97U/L) with p=0.086. However, the levels of mean serum amylase were higher in cases (76.40 ± 33.86 U/L) compared to that in controls (69.66 ± 16.45U/L) with p= 0.210. Serum amylase activity was raised in 8% of the patients whereas the activity of pancreatic lipase was within normal range. Serum glucose levels were lower in cases (84.72 ± 11.28 mg/dl) than that in controls (87.04 ± 10.65 mg/dl) with p=0.293. Conclusions: From this study we conclude that lipase activity was statistically insignificant in hyperemesis gravidarum. Therefore, pancreatic activities were less affected by hyperemesis gravidarum. So, this condition needs further exploration regarding biochemical basis to minimize the risk associated with it. 

scholarly journals Man with epigastric pain and persistently elevated serum lipase

2019 ◽  
Vol 12 (4) ◽  
pp. e229208
Author(s):  
Caroline Annette Erika Bachmeier ◽  
Adam Morton
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Epigastric Pain ◽  
Elevated Serum ◽  
Pancreatic Disease ◽  
Radiological Assessment ◽  
Serum Lipase ◽  
Persistent Elevation ◽  
Assay Interference ◽  
Laboratory Assay

Serum lipase and amylase are commonly requested in individuals presenting with abdominal pain for investigation of acute pancreatitis. Pancreatic hyperenzymaemia is not specific for acute pancreatitis, occurring in many other pancreatic and non-pancreatic conditions. Where persistent elevation of serum lipase and amylase occurs in the absence of a diagnosed cause or evidence of laboratory assay interference, ongoing radiological assessment for pancreatic disease is required for 24 months before a diagnosis of benign pancreatic hyperenzymaemia can be made. We report a case of a 71-year-old man with epigastric pain and elevated serum lipase levels. He was extensively investigated, but no pancreatic disease was detected. He is asymptomatic, but serum lipase levels remain elevated 18 months after his initial presentation.

scholarly journals A study to identify clinical and laboratory parameters in cases of excessive vomiting in early pregnancy

2021 ◽  
Vol 10 (12) ◽  
pp. 4424
Author(s):  
Dyuti Dubey ◽  
Usha Agrawal ◽  
Rekha Sapkal
Keyword(s):  
Early Pregnancy ◽  
Hyperemesis Gravidarum ◽  
Serum Alkaline Phosphatase ◽  
Clinical Problem ◽  
First Trimester ◽  
Nausea And Vomiting ◽  
Severe Nausea ◽  
Laboratory Parameters ◽  
Study Population ◽  
Clinical Conditions

Background: Around half of all pregnant women experience vomiting, and more than 80% of women experience nausea in the first 12 weeks. Women with severe nausea and vomiting during pregnancy may have hyperemesis gravidarum (HG), an entity distinct from nausea and vomiting of pregnancy (NVP), which if left untreated may lead to significant maternal and foetal morbidity. In our study, we studied, clinical and laboratory parameters in patients presenting with excessive vomiting. The study may help in evaluating what is the major clinical problem encountered during treatment and how many days of care are needed in such cases.Methods: The study design was a prospective observational study. Patients attending the ANC clinic and emergency indoor cases at Peoples college of medical sciences, Bhopal were considered as study population. 100 patients who satisfied inclusion and exclusion criteria were included in the study. Patient’s sociodemographic variables, detailed obstetric history, clinical and laboratory parameters were recorded. Results obtained were analysed and tabulated.Results: Persistence of vomiting in the first trimester leading to dehydration and hospitalization was documented in 12% of patients. The 5% of then had metabolic acidosis and 1% required correction of starvation ketoacidosis, but there was not significant weight loss observed in any of the case. Liver function test were normal in almost in all cases except 9% had raised serum alkaline phosphatase levels.Conclusions: All cases with vomiting in early pregnancy should receive attention and exclusion of all emergency clinical conditions. Patient should be screened for urine tract infection and diabetes in all cases. 

scholarly journals Acute Pancreatitis Associated with Amoebic Liver Abscess

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Jayant Kumar Ghosh ◽  
Vinod Kumar Dixit ◽  
Sangey Chopel Lamtha ◽  
Sundeep Kumar Goyal ◽  
Pankaj Kaushik
Keyword(s):  
Acute Pancreatitis ◽  
Liver Abscess ◽  
Rare Case ◽  
Elevated Serum ◽  
Amoebic Liver Abscess ◽  
Serum Lipase ◽  
Right Lobe

We present a rare case of acute pancreatitis in a 50-year-old man with amoebic liver abscess. He had a right lobe liver abscess along with markedly elevated serum lipase and amylase levels and edematous pancreas. Liver abscess was aspirated. The patient was managed conservatively with antibiotics and improved without any complications. Acute pancreatitis associated with ALA is not reported in the literature till date.

scholarly journals SAT-568 Hypertriglyceridemia-Induced Pancreatitis in a Pregnant Female Treated with Plasmapheresis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Priti Nath ◽  
Mohammed Shakir ◽  
Thanh Duc Hoang
Keyword(s):  
Acute Pancreatitis ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Medical Therapy ◽  
Elevated Serum ◽  
Pregnant Female ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Laboratory Findings ◽  
Serum Lipase

Abstract Hypertriglyceridemia-Induced Pancreatitis in a Pregnant Female Treated with Plasmapheresis Background: Gestational hypertriglyceridemia can lead to critical and even life-threatening consequences to both mother and fetus. A well-known consequence is hypertriglyceridemia-induced acute pancreatitis. Few case reports described the successful management of triglyceride (TG) induced pancreatitis in pregnant women using plasmapheresis. Clinical Case: A 28-year-old primigravida patient, in the 29th week of gestation, was admitted with acute onset of epigastric pain and nausea for 24 hours. Laboratory findings were remarkable for an elevated serum lipase of 505 U/L (ref 23–300) and an abnormal lipid profile. Her total cholesterol was 1651 mg/dl and triglycerides (TG) from an undiluted sample was 1361 mg/dl. When a 1:5 dilution was performed the result was higher at >4000 mg/dl. She was transferred to the ICU for treatment of acute pancreatitis. She has no family history of hypertriglyceridemia. No MRI was obtained. Gemfibrozil, Lovaza™ (omega-3-acid ethyl esters), and an insulin infusion were started but serum TG levels did not improve. On hospital day 2 she developed worsening tachycardia, tachypnea with laboratory findings of metabolic acidosis and hypocalcemia. As there was no reduction in triglyceride levels with medical therapy and her clinical status was deteriorating, the treating multidisciplinary team decided to initiate plasmapheresis. After one session, TG levels decreased from >4000 mg/dl to 1829 mg/dl and continued to decline to 721 mg/dl. Hospital day 6 her TG level rose to 1245 mg/dl prompting a second plasmapheresis. TG levels decreased to 770 mg/dl shortly after but rose the next day to 1365 mg/dl. She underwent a 3rd plasmapheresis after which her TG ranged from 400–700 mg/dl for the remainder of her hospitalization. On the day of discharge, her TG level was 733 mg/dl. She was advised to restrict fat intake and continue both gemfibrozil and Lovaza™ but despite this her TGs again increased to 1693 mg/dl. From that point she started weekly sessions of plasmapheresis for a total of 8 sessions prior to an uneventful vaginal delivery at 36 weeks of gestation. One month later her lipid profile dramatically improved. Total cholesterol was 233 mg/dl and triglycerides were 304 mg/dl while on lipid lowering therapy. Conclusion: Pancreatitis during pregnancy is associated with a high maternal and fetal death rate. Early treatment is important for the survival of the mother and fetus. Plasmapheresis is an alternative and safe treatment for cases that are not responsive to medical therapy. It can be administered safely to reduce triglyceride levels and diminish the systemic inflammatory response leading to a shortened hospital stay and better outcomes.

scholarly journals Case of acute abdomen due to acute pancreatitis: a uncommon presentation of leptospirosis

2019 ◽  
Vol 7 (8) ◽  
pp. 3183
Author(s):  
Zubin Pradeep Sharma ◽  
Divya Sharma ◽  
Ravindra Sharma
Keyword(s):  
Acute Pancreatitis ◽  
Acute Abdomen ◽  
Clinical Features ◽  
Elevated Serum ◽  
Serum Lipase ◽  
Uncommon Presentation ◽  
Gastrointestinal Manifestation

 Even though, Leptospiral infection is not rare, it can have different rare presentations. Acute pancreatitis is one such uncommon gastrointestinal manifestation of acute pancreatitis. Apart from the classic clinical features, elevated serum lipase, along with radiological proof and positive leptospiral serology confirms this infrequent association. 

Akathisia preceding an oculogyric crisis in a patient treated with prochlorperazine for hyperemesis gravidarum

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Patrick Williams ◽  
Haim Abenhaim
Keyword(s):  
Hyperemesis Gravidarum ◽  
Nausea And Vomiting ◽  
Class I ◽  
Dopaminergic Receptors ◽  
Severe Nausea ◽  
Behavioural Changes ◽  
Oculogyric Crisis ◽  
Threatening Condition ◽  
Life Threatening ◽  
In Pregnancy

AbstractProchlorperazine is a class I-A anti-emetic recommended for the treatment of severe nausea and vomiting in pregnancy. We present a case where a patient presented with hyperemesis gravidarum refractory to pyridoxine/doxylamine and dimenhydrinate and developed akathisia and dystonia after receiving prochlorperazine. Her condition resolved immediately following the administration of diphenhydramine. While procholorperazine is known to very rarely cause focal dystonias such as an oculogyric crisis, the influence of phenothiazines and neuroleptics on dopaminergic receptors can also trigger behavioural changes, which can rapidly evolve into a life-threatening condition.

High Prevalence of Severe Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum Among Relatives of Affected Individuals

2009 ◽  
Vol 64 (3) ◽  
pp. 148-149
Author(s):  
Marlena S. Fejzo ◽  
Sue Ann Ingles ◽  
Melissa Wilson ◽  
Wei Wanga ◽  
Kimber MacGibbon ◽  
...  
Keyword(s):  
Hyperemesis Gravidarum ◽  
Nausea And Vomiting ◽  
Severe Nausea ◽  
High Prevalence

scholarly journals Analysis of GDF15 and IGFBP7 in Hyperemesis Gravidarum Support Causality

2019 ◽  
Vol 79 (04) ◽  
pp. 382-388 ◽  
Author(s):  
Marlena Fejzo ◽  
Peter Fasching ◽  
Michael Schneider ◽  
Judith Schwitulla ◽  
Matthias Beckmann ◽  
...  
Keyword(s):  
Hyperemesis Gravidarum ◽  
Familial Aggregation ◽  
Twin Studies ◽  
Serum Levels ◽  
Nausea And Vomiting ◽  
Electrolyte Imbalance ◽  
Significant Weight Loss ◽  
Control Groups ◽  
Severe Nausea ◽  
In Pregnancy

Abstract Objective Hyperemesis gravidarum, severe nausea and vomiting in pregnancy, occurs in up to 2% of pregnancies and leads to significant weight loss, dehydration, electrolyte imbalance, and ketonuria. It is associated with both maternal and fetal morbidity. Familial aggregation studies and twin studies suggest a genetic component. In a recent GWAS, we showed that placentation, appetite, and cachexia genes GDF15 and IGFBP7 are linked to hyperemesis gravidarum (HG). The purpose of this study is to determine whether GDF15 and IGFBP7 are upregulated in HG patients. Methods We compared serum levels of GDF15 and IGFBP7 at 12 and 24 weeksʼ gestation in women hospitalized for HG, and two control groups, women with nausea and vomiting of pregnancy (NVP), and women with no NVP. Results We show GDF15 and IGFBP7 serum levels are significantly increased in women with HG at 12 weeksʼ gestation. Serum levels of hCG are not significantly different between cases and controls. At 24 weeks gestation, when symptoms have largely resolved, there is no difference in GDF15 and IGFBP7 serum levels between cases and controls. Conclusion This study supports GDF15 and IGFBP7 in the pathogenesis of HG and may be useful for prediction and diagnosis. The GDF15-GFRAL brainstem-activated pathway was recently identified and therapies to treat conditions of abnormal appetite are under intense investigation. Based on our findings, HG should be included.

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