Core Surgical Trainee, Department of Surgical Paediatrics, Royal Hospital for Children Glasgow, Glasgow, UK.
Specialist Trainee in Paediatric Surgery, Department of Surgical Paediatrics, Royal Hospital for Children Glasgow, Glasgow, UK.
Scott Med J. 2019 Nov;64(4):138-141. doi: 10.1177/0036933019865168. Epub 2019 Jul 26.
Capillary (finger prick) blood sampling is commonplace in paediatric practice but this method is prone to produce spurious laboratory results.
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.
Increased awareness of the potential for salivary contamination of serum amylase in finger prick samples may prevent misdiagnoses of pancreatitis.
毛细血管（指尖）采血在儿科实践中很常见，但这种方法容易产生虚假的实验室结果。
一名 5 岁女孩因腹痛、上腹痛、心动过速和血氧饱和度降低而就诊。静脉血样溶血，指尖样本人血清淀粉酶报告为 2831 单位/升。初步诊断为急性胰腺炎和呼吸道感染。9 小时后重复淀粉酶检查在正常范围内。已知该患者有咬手指的习惯，因此考虑唾液污染的可能性。血清同工酶分析证实存在高唾液淀粉酶水平，而未检测到胰腺淀粉酶。最终认为病毒性呼吸道感染和埋藏式胃造口管 bumper 导致了该患者的就诊。
提高对手指采血样本中唾液污染血清淀粉酶的潜在风险的认识，可能有助于避免胰腺炎的误诊。
