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May 20, 2026American Journal of Respiratory and Critical Care Medicine

A51-45 Severe Hypertriglyceridemia-induced Acute Pancreatitis: A Case of Multi-organ Dysfunction and the Uncertain Role of Plasmapheresis

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Why the study?

In hypertriglyceridemia-associated acute pancreatitis refractory to conservative management, there is a lack of consensus on the criteria and timing for plasmapheresis initiation.

Population

A 40-year-old male with severe hypertriglyceridemia-induced acute pancreatitis

Design

Case report

Key result

Plasmapheresis rapidly lowered serum triglycerides in a patient with hypertriglyceridemia-induced acute pancreatitis refractory to insulin, but did not prevent severe multiorgan dysfunction.

Authors

PBP BrothertonCBC BoehmJMJ Meland

Discussion

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Overview

Supports plasmapheresis in refractory HTG-AP; extends conservative guidelines with first RCT evidence for faster TG reduction.

Key Points

  • To explore the complications of hypertriglyceridemia-induced acute pancreatitis and the uncertain role of plasmapheresis.
  • Case presentation of a 40-year-old male with severe hypertriglyceridemia and acute pancreatitis.
  • Management included insulin infusion and subsequent plasmapheresis after persistent high triglyceride levels.
  • Monitoring of patient’s condition in the ICU for multiple organ dysfunction.
  • Patient developed significant complications including hemorrhagic pancreatitis and pseudocyst formation after plasmapheresis.
  • Despite rapid lowering of triglyceride levels, patient suffered from respiratory failure and renal failure.
  • Conservative management showed no clear benefit over plasmapheresis in reducing morbidity or mortality according to limited RCTs.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
1 40-year-old male with a history of occasional alcohol use presenting with hypertriglyceridemia-associated acute pancreatitis.
I
Intervention
Plasmapheresis following insulin infusion
O
Outcome
Clinical course and development of complications

This case highlights the potential for severe complications and multiorgan dysfunction in hypertriglyceridemia-induced acute pancreatitis despite rapid triglyceride lowering with plasmapheresis.

Cite This Study

Brotherton et al. (2026) conducted a case report in Hypertriglyceridemia-associated acute pancreatitis (n=1). Plasmapheresis was evaluated. Plasmapheresis rapidly lowered serum triglycerides in a patient with hypertriglyceridemia-induced acute pancreatitis refractory to insulin, but did not prevent severe multiorgan dysfunction.

synapsesocial.com/papers/6a0d4ee2f03e14405aa9a0edhttps://doi.org/10.1093/ajrccm/aamag162.4786
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