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Pseudohyponatremia in Hypertriglyceridemia-Induced Acute Pancreatitis: A Tool for Diagnosis Rather Than Merely a Laboratory Error?
Pancreas 2019; 48(1):126-130P

Abstract

OBJECTIVES

The relative rarity of hypertriglyceridemia (HTG) as the etiology for acute pancreatitis (AP) delays the final diagnosis of hypertriglyceridemia-induced AP (HTG-AP). This study aimed to explore the diagnostic and prognostic value of pseudohyponatremia in this clinical entity.

METHODS

We retrospectively compared 140 patients with HTG-AP and 266 patients of AP of other etiologies. The correlation of presenting hyponatremia and a final diagnosis of HTG-AP is evaluated.

RESULTS

Presenting hyponatremia had an area under curve of 0.926 for predicting the diagnosis of HTG-AP. After dichotomization by the optimal cutoff value of 130 mEq/dL, patients with hyponatremia had a higher prevalence of acute kidney injury (61.9% vs 38.1%, P < 0.001), systemic inflammatory response syndrome (52.2% vs 47.8%, P < 0.001), a higher Ranson criteria (3.0 vs 1.4, P < 0.001), and a higher Bedside Index for Severity of Acute Pancreatitis score (0.69 vs 0.55, P = 0.011).

CONCLUSIONS

Presenting hyponatremia is highly efficient in differentiating hypertriglyceridemia from other etiologies of AP. It also demonstrated promising prognostic values in both AP and HTG-AP patients. Therefore, initial serum sodium could potentially provide the first clue of HTG-AP, as well as facilitate risk-stratifying patients to determine treatment allocation.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30540682

Citation

Wang, Yuchen, et al. "Pseudohyponatremia in Hypertriglyceridemia-Induced Acute Pancreatitis: a Tool for Diagnosis Rather Than Merely a Laboratory Error?" Pancreas, vol. 48, no. 1, 2019, pp. 126-130.
Wang Y, Attar BM, Abu Omar Y, et al. Pseudohyponatremia in Hypertriglyceridemia-Induced Acute Pancreatitis: A Tool for Diagnosis Rather Than Merely a Laboratory Error? Pancreas. 2019;48(1):126-130.
Wang, Y., Attar, B. M., Abu Omar, Y., Agrawal, R., & Demetria, M. V. (2019). Pseudohyponatremia in Hypertriglyceridemia-Induced Acute Pancreatitis: A Tool for Diagnosis Rather Than Merely a Laboratory Error? Pancreas, 48(1), pp. 126-130. doi:10.1097/MPA.0000000000001192.
Wang Y, et al. Pseudohyponatremia in Hypertriglyceridemia-Induced Acute Pancreatitis: a Tool for Diagnosis Rather Than Merely a Laboratory Error. Pancreas. 2019;48(1):126-130. PubMed PMID: 30540682.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pseudohyponatremia in Hypertriglyceridemia-Induced Acute Pancreatitis: A Tool for Diagnosis Rather Than Merely a Laboratory Error? AU - Wang,Yuchen, AU - Attar,Bashar M, AU - Abu Omar,Yazan, AU - Agrawal,Rohit, AU - Demetria,Melchor V, PY - 2018/12/13/entrez PY - 2018/12/13/pubmed PY - 2019/6/25/medline SP - 126 EP - 130 JF - Pancreas JO - Pancreas VL - 48 IS - 1 N2 - OBJECTIVES: The relative rarity of hypertriglyceridemia (HTG) as the etiology for acute pancreatitis (AP) delays the final diagnosis of hypertriglyceridemia-induced AP (HTG-AP). This study aimed to explore the diagnostic and prognostic value of pseudohyponatremia in this clinical entity. METHODS: We retrospectively compared 140 patients with HTG-AP and 266 patients of AP of other etiologies. The correlation of presenting hyponatremia and a final diagnosis of HTG-AP is evaluated. RESULTS: Presenting hyponatremia had an area under curve of 0.926 for predicting the diagnosis of HTG-AP. After dichotomization by the optimal cutoff value of 130 mEq/dL, patients with hyponatremia had a higher prevalence of acute kidney injury (61.9% vs 38.1%, P < 0.001), systemic inflammatory response syndrome (52.2% vs 47.8%, P < 0.001), a higher Ranson criteria (3.0 vs 1.4, P < 0.001), and a higher Bedside Index for Severity of Acute Pancreatitis score (0.69 vs 0.55, P = 0.011). CONCLUSIONS: Presenting hyponatremia is highly efficient in differentiating hypertriglyceridemia from other etiologies of AP. It also demonstrated promising prognostic values in both AP and HTG-AP patients. Therefore, initial serum sodium could potentially provide the first clue of HTG-AP, as well as facilitate risk-stratifying patients to determine treatment allocation. SN - 1536-4828 UR - https://www.unboundmedicine.com/medline/citation/30540682/Pseudohyponatremia_in_Hypertriglyceridemia-Induced_Acute_Pancreatitis:_A_Tool_for_Diagnosis_Rather_Than_Merely_a_Laboratory_Error L2 - http://Insights.ovid.com/pubmed?pmid=30540682 DB - PRIME DP - Unbound Medicine ER -