ROSH Gastrointestinal Practice Exam

What lab finding suggests an increased risk for pancreatitis complications?

1. Amylase 120 units/L

2. Lactate dehydrogenase 180 units/L

3. White blood cell count 25,000 cells/mcL

4. Serum lipase 400 units/L

The correct answer is: White blood cell count 25,000 cells/mcL

An elevated white blood cell count is a significant indicator of systemic inflammation and can suggest a more severe or complicated course of pancreatitis. In the setting of pancreatitis, particularly when the white blood cell count rises to levels such as 25,000 cells/mcL, it could indicate complications such as infection, necrotizing pancreatitis, or the presence of associated conditions like abscesses or sepsis. In contrast, elevated levels of amylase and lipase, while they indicate pancreatic inflammation, do not necessarily correlate with the severity of the condition or the risk of complications. An amylase level of 120 units/L is above the normal range, but it is not exceptionally high and does not indicate an increased risk for complications. Similarly, a serum lipase level of 400 units/L is indicative of pancreatitis but is not as directly linked to complications as a markedly elevated white blood cell count. Lactate dehydrogenase (LDH) levels can be elevated in various conditions, but a lower level like 180 units/L does not specifically suggest a higher complication risk in the context of pancreatitis. Thus, the white blood cell count being significantly elevated highlights a potentially serious infection or inflammatory response, suggesting an increased risk for complications