Johnson Amanda, Cluskey Bethany, Hooshvar Nina, Tice Daphne, Devin Courtney, Kao Elaine, Nawabi Suhalia, Jones Steven, Zhang Lihua, Dola Chi
Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, SL-11, Tulane School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA.
Department of General Surgery, Tulane School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA.
Case Rep Obstet Gynecol. 2015;2015:359239. doi: 10.1155/2015/359239. Epub 2015 Feb 2.
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.
妊娠剧吐是妊娠期恶心和呕吐的严重表现，与体重减轻和代谢异常有关。已知包括血清脂肪酶水平轻度升高在内的实验室检查值异常可能与妊娠剧吐有关。然而，在本病例报告中，讨论了两名妊娠剧吐但血清脂肪酶水平显著升高的女性的详细情况。这些患者表现为严重恶心和呕吐，但无腹痛。发现她们的脂肪酶水平严重升高，超过1000单位/升。在没有胰腺炎的其他表现的情况下，她们接受了妊娠剧吐的保守治疗，最终脂肪酶水平恢复正常。虽然恶心呕吐的孕妇脂肪酶水平显著升高令人担心急性胰腺炎，但这两例血清脂肪酶显著升高而无胰腺炎其他临床症状的病例促成了本报告，即妊娠剧吐时血清脂肪酶可能会大幅升高，且它可能不是急性胰腺炎的准确生化标志物。因此，需要进行影像学检查来确诊急性胰腺炎。
