Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2024; 30(19): 2538-2552
Published online May 21, 2024. doi: 10.3748/wjg.v30.i19.2538
Non-pancreatic hyperlipasemia: A puzzling clinical entity
Krisztina Eszter Feher, David Tornai, Zsuzsanna Vitalis, Laszlo Davida, Nora Sipeki, Maria Papp
Krisztina Eszter Feher, David Tornai, Zsuzsanna Vitalis, Laszlo Davida, Nora Sipeki, Maria Papp, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen H-4032, Hajdu-Bihar, Hungary
Krisztina Eszter Feher, Kalman Laki Doctoral School of Biomedical and Clinical Sciences, Faculty of Medicine, University of Debrecen, Debrecen H-4032, Hungary
Author contributions: Feher KE, Papp M and Vitalis Z made the concept and designed the present study; Feher KE and Davida L were responsible for clinical data acquisition; Tornai D and Sipeki N made the laboratory measurement and were responsible for laboratory data acquisition; Tornai D, Feher KE, Sipeki N, Papp M made the analysis and interpretation of the data, and wrote paper; Papp M and Vitalis Z and Davida L supervised the work, provided expert insights and made critical revisions related to important intellectual content of the manuscript; All authors have read and approved the final manuscript.
Supported by the Economic Development and Innovation Operative Program Grant, No. GINOP 2.3.2- 15-2016-00048 “StayAlive”; and Human Resources Development Operational Program Grant of the National Research Development and Innovation Office, No. EFOP-3.6.2-16-2017-00006.
Institutional review board statement: The study was reviewed and approved by the Committee of Science and Research Ethics of the Hungarian Medical Research Council (ETT TUKEB) and the Regional and Institutional Committee of Science and research Ethics of the University of Debrecen (RKEB) (305/2014, 30595-1/2014 EKU, 55961-2/2016/EKU, 5753-2/2018 EKU).
Clinical trial registration statement: Our manuscript is an observational study based on a prospective data collection driven from the screening process of the Early Achievable Severit Y (EASY) trial (Registration number: ISRCTN10525246). However, patients with non-pancreatic hyperlipasemia who are the focus of our present study, were screened but not enrolled to the trial. Furthermore, all patients included in the current study are exclusively recruited from our clinic, while the trial was a multi centre investigation.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Patients' clinical data cannot be made public according to Hungarian law, but anonymized data can be obtained from the corresponding author on reasonable request at papp.maria@med.unideb.hu.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maria Papp, DSc, FEBG, MD, PhD, Professor, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Blv 98, Debrecen H-4032, Hajdu-Bihar, Hungary. papp.maria@med.unideb.hu
Received: January 1, 2024
Revised: March 7, 2024
Accepted: April 23, 2024
Published online: May 21, 2024
Processing time: 139 Days and 9.3 Hours
Core Tip

Core Tip: Non-pancreatic hyperlipasemia is a common and puzzling clinical entity in the differential diagnosis of acute pancreatitis (AP). The etiology of NPHL varies; however, sepsis and acute kidney injury (AKI) are the most prevalent causes. NPHL was associated with a high in-hospital mortality rate (22.4%). A readily available laboratory marker, the neutrophil-to-lymphocyte ratio, with a cut-off value > 10.37, has been the best independent laboratory predictor of mortality, with a nearly 4-fold increased risk. In the laboratory diagnosis of AP, the presence of complications, especially sepsis and AKI, warrants clinical attention, as it has a significant negative impact on the diagnostic accuracy of lipase.