Spuriously raised serum amylase in a five-year-old girl: a note of caution in paediatric blood sampling

Introduction Capillary (finger prick) blood sampling is commonplace in paediatric practice but this method is prone to produce spurious laboratory results. Case presentation A five-year-old girl presented with abdominal pain, epigastric tenderness, tachycardia and reduced oxygen saturation. A venous blood sample haemolysed, and serum amylase on a finger prick sample was reported as 2831 units/L. The working diagnosis was acute pancreatitis and respiratory tract infection. A repeat amylase 9 h later was within the normal range. The patient was known to bite her fingers and the possibility of salivary contamination was considered. Serum isoenzyme analysis confirmed presence of high salivary amylase levels with no pancreatic amylase detected. A viral respiratory tract infection and buried gastrostomy bumper were eventually thought to account for the patient’s presentation. Conclusion Increased awareness of the potential for salivary contamination of serum amylase in finger prick samples may prevent misdiagnoses of pancreatitis.

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Recovery from a Viral Respiratory Tract Infection: III. Specificity of Protection Conferred by Immune Spleen Cells Stimulated In Vitro

Genetic Variation Among Influenza Viruses ◽

10.1016/b978-0-12-515080-4.50049-3 ◽

1981 ◽

pp. 577-585 ◽

Cited By ~ 2

Author(s):

Francis A. Ennis ◽

Martha A. Wells

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Spleen Cells ◽

Viral Respiratory Tract Infection ◽

Viral Respiratory ◽

Immune Spleen Cells

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Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung Transplantation

Transplantation Direct ◽

10.1097/txd.0000000000000808 ◽

2018 ◽

Vol 4 (8) ◽

pp. e370 ◽

Cited By ~ 9

Author(s):

Jesper Magnusson ◽

Johan Westin ◽

Lars-Magnus Andersson ◽

Magnus Lindh ◽

Robin Brittain-Long ◽

...

Keyword(s):

Risk Factor ◽

Tract Infection ◽

Respiratory Tract ◽

Lung Transplantation ◽

Respiratory Tract Infection ◽

Chronic Rejection ◽

Viral Respiratory Tract Infection ◽

Viral Respiratory

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Eustachian Tube Histopathology during Experimental Influenza a Virus Infection in the Chinchilla

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948709600212 ◽

1987 ◽

Vol 96 (2) ◽

pp. 199-206 ◽

Cited By ~ 52

Author(s):

G. Scott Giebink ◽

Mary Lou Ripley ◽

Peter F. Wright

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Influenza A Virus ◽

Middle Ear ◽

Influenza A ◽

Middle Ear Pressure ◽

Viral Respiratory Tract Infection ◽

Pathologic Basis ◽

Viral Respiratory

The eustachian tubes of 29 influenza a virus–infected chinchillas were examined for histopathologic signs at intervals up to 21 days after inoculation to elucidate the pathologic basis of negative middle ear pressure, which occurs during viral respiratory tract infection in humans. In the animal model, eardrum inflammation and negative middle ear pressure mirrored epithelial damage in the eustachian tube and the accumulation of cellular and mucous debris in the tubal lumen. Epithelial damage was greatest in the proximal two thirds of the tube near the nasopharynx, whereas goblet cell metaplasia and increased secretory activity was greatest in the distal, tympanic one third of the tube. These results provide a morphologic correlate to the development of negative middle ear pressure, and perhaps explain the pathologic basis for purulent otitis media during viral respiratory tract infection.

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