Hypertriglyceridemia accounts for up to 10% of all acute pancreatitis cases and up to 50% in pregnancy, with management involving apheresis, insulin, and long-term dietary modifications.
This review highlights that hypertriglyceridemia is a significant cause of acute pancreatitis, with management involving apheresis, insulin, heparin, lipid-lowering agents, and dietary modifications.
PURPOSE OF REVIEW: Hypertriglyceridemia (HTG) is a well recognized cause of acute pancreatitis accounting for approximately up to 10% of all cases and even up to 50% of all cases in pregnancy. Both primary and secondary disorders of lipoprotein metabolism may be associated with hypertriglyceridemic pancreatitis (HTGP). The purpose of this review is to provide an overview of the current studies on presentation and management of HTGP. RECENT FINDINGS/CONCLUSION: Hydrolysis of triglycerides by pancreatic lipase and formation of free fatty acids that induce inflammatory changes are postulated to account for the development of HTGP, yet the exact pathophysiology remains unclear. The clinical features of patients with HTGP are generally not different from patients with acute pancreatitis of other causes, and there is some evidence that HTGP is associated with a higher severity or a higher complication rate. There is no clear evidence as to which HTG patients will develop pancreatitis. Several studies have evaluated the effect of apheresis, the benefit of insulin and/or heparin treatment and the use of different antihyperlipidemic agents in HTGP. Dietary modifications resemble the key features in the long-term management of HTG. Whether HTG may cause chronic pancreatitis in the long-term follow-up remains controversial.
Ewald et al. (Tue,) conducted a review in Hypertriglyceridemic pancreatitis. Management strategies (apheresis, insulin, heparin, antihyperlipidemic agents, dietary modifications) was evaluated. Hypertriglyceridemia accounts for up to 10% of all acute pancreatitis cases and up to 50% in pregnancy, with management involving apheresis, insulin, and long-term dietary modifications.