Atypical eating disorder masquerading as recurrent acute pancreatitis: The value of multiple pancreatic serological markers

Russell I. Heigh, Jonathan Matz, Ingram M. Roberts, William M. Steinberg, James P. Henry

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

A 28-year-old woman with nausea, vomiting, and abdominal pain had been hospitalized elsewhere on 13 separate occasions over the year before this admission for similar episodes thought to be secondary to acute pancreatitis. She had undergone repeated work-ups including endoscopic retrograde cholangiopancreatography, computed tomographic scan, and exploratory laparotomy. There was a discrepancy between her unremarkable physical examination and extremely elevated amylase (3,210 U/L) which suggested nonpancreatic hyperamylasemia; normal serum pancreatic isoamylase, trypsinogen, and lipase confirmed this suspicion. The patient was noted to have self-induced vomiting in the hospital which she admitted was frequent behavior. Her psychiatric disturbance was characterized as an atypical eating disorder. This case illustrates that hyperamylasemia in association with abdominal pain, nausea, and vomiting may not be secondary to pancreatitis and that use of a second serum marker (such as trypsinogen, lipase, or isoamylase) helps to establish a definitive diagnosis.

Original languageEnglish (US)
Pages (from-to)78-80
Number of pages3
JournalJournal of clinical gastroenterology
Volume12
Issue number1
DOIs
StatePublished - Feb 1990

Keywords

  • Eating disorder
  • Hyperamylasemia
  • Lipase
  • Pancreatitis
  • Psychiatric disturbance
  • Trypsinogen

ASJC Scopus subject areas

  • Gastroenterology

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