PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of bmjcrBMJ Case ReportsVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
 
BMJ Case Rep. 2010; 2010: bcr0320102821.
Published online 2010 August 10. doi:  10.1136/bcr.03.2010.2821
PMCID: PMC3027994
Unusual association of diseases/symptoms

Tramadol poisoning with hyperamylasemia

Abstract

The usual reason for measuring serum amylase level is to confirm or exclude the diagnosis of pancreatitis. However, increases in serum amylase levels can occur in conditions other than pancreatitis and many of those conditions present with acute abdominal pain. In the case presented here, an unconscious patient developed a very high serum total amylase level, which was most likely due to hypoxemia and lactic acidosis secondary to an overdose of Tramadol (Nobligan) tablets. The patient was treated in the intensive care unit and had an uneventful recovery. Many diseases can cause acute elevation of serum amylase level. In lactic acidosis, the hyperamylasemia typically results from the presence of excessive salivary-type isoamylase. Therefore, isoamylase enzyme analysis is of great clinical value in the differential diagnosis of hyperamylasemia, especially in cases with concurrent lactic acidosis.


Articles from BMJ Case Reports are provided here courtesy of BMJ Group