Severe acute pancreatitis with normal lipase serum level complicating leukemoid reaction

Severe acute pancreatitis is characterised by the presence of abdominal pain, increased concentrations of serum amylase and lipase, local or systemic complications. We report the case of a severe acute pancreatitis with normal lipase serum level who was finally diagnosed by computed tomography (CT)scan. Moreover the patient had a rare complication of severe acute pancreatitis, that presents as extremely high white blood cell count with immature leucocytes in the peripheral blood. Severe acute pancreatitis is usually diagnosed based on clinical and laboratory data. On the basis of our atypical findings, we stress the possibility of severe acute pancreatitis even without increased concentations of serum lipase.