Falsely elevated triglyceride and lipase levels due to hyperglycerolemia in a burn patient treated with topical silver sulfadiazine
Issued Date
2024-01-01
Resource Type
ISSN
19332874
eISSN
18764789
Scopus ID
2-s2.0-85210000316
Journal Title
Journal of Clinical Lipidology
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SCOPUS
Bibliographic Citation
Journal of Clinical Lipidology (2024)
Suggested Citation
Sriphrapradang C., Srisawasdi P., Shantavasinkul P.C., Auparakkitanon S., Krongvorakul J., Punprasit S., Wongdama S. Falsely elevated triglyceride and lipase levels due to hyperglycerolemia in a burn patient treated with topical silver sulfadiazine. Journal of Clinical Lipidology (2024). doi:10.1016/j.jacl.2024.10.006 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/102260
Title
Falsely elevated triglyceride and lipase levels due to hyperglycerolemia in a burn patient treated with topical silver sulfadiazine
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Abstract
Pseudohypertriglyceridemia is an overestimation of serum triglyceride levels, potentially leading to an inaccurate diagnosis of hypertriglyceridemia. This can result from hyperglycerolemia, which interferes with enzymatic measurement methods. Hyperglycerolemia may arise from drugs or genetic glycerol kinase defects. We present a case of a severely burned patient with very high triglyceride levels (up to 5,696 mg/dL) that was resistant to lipid-lowering treatment, identified during the work up for pancreatitis associated with elevated lipase levels. Despite the very high triglyceride levels reported in the laboratory results, the standing plasma showed clear plasma, with no significant peak of pre-beta lipoprotein observed on serum lipoprotein electrophoresis. Serum apolipoprotein B levels were low, and urine triglyceride levels were high. This case confirms that very high serum glycerol levels caused the falsely elevations of triglyceride and lipase levels, resulting from hyperglycerolemia induced by the massive topical application of silver sulfadiazine cream (containing glycerine and glyceryl stearate) to the severely burned wound, which interfered with the laboratory assays. Triglyceride and lipase levels dramatically decreased after reducing the dose of silver sulfadiazine cream. No genetic defects related to glycerol kinase deficiency were identified.