SFGH 3.23 am report pearls: lipase, diabetes, and cirrhosis, oh my!

  • In a study of 135 patients with DKA, 24% were found to have nonspecific lipase elevation defined as an elevated lipase and CT scan without pancreatitis.  8% had lipase elevations >3x the upper limit of normal.  In multiple regression analyses there was a correlation with serum osmolality.
  • Chorea, hemichorea-hemiballismus and severe partial seizures may be the presenting features of nonketotic hyperglycemia in type 2 diabetes
  • Does this patient have cirrhosis? (from the JAMA rational clinical exam series)
    • Increased likelihood: history of diabetes, ascites on exam, platelet count <160
    • Lower likelihood: absence of hepatomegaly, platelet count >160

Yadav D., Nair S, Norkus EP, Pitchumoni CS.  Nonspecific hyperamylasemia and hyperlipasemia in DKA: incidence and correlation with biochemical abnormalities.  Am J Gastroenterol. 2000 Nov; 95(11): 3123-8.

Udell et al.  Does This Patient with Liver Disease Have Cirrhosis? JAMA 2012 Feb; 307(8).

Evernote link: http://www.evernote.com/l/AoOVmyFuYgJJlbrDyGvRAdELZpug8KycIUw/

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