Why the study?
Does continuous intravenous insulin infusion improve outcomes in a pediatric patient with severe hypertriglyceridemia, acute pancreatitis, and diabetic ketoacidosis?
Does continuous intravenous insulin infusion improve outcomes in a pediatric patient with severe hypertriglyceridemia, acute pancreatitis, and diabetic ketoacidosis?
Continuous intravenous insulin infusion can be an effective emergency treatment for severe hypertriglyceridemia complicated by acute pancreatitis and diabetic ketoacidosis in pediatric patients.
May support insulin infusion in this rare pediatric triad; hypothesis-generating and should not yet change practice.
Severe hypertriglyceridemia (SH) represents a therapeutic emergency because of the possibility of developing cardiovascular events and hyperlipemic acute pancreatitis (PA). Most patients with SH suffer primary or genetic abnormality in lipid metabolism in combination with a precipitating factor such as uncontrolled diabetes mellitus, alcoholism, and drug intake. The standard treatment of hypertriglyceridemia (HTG) with omega 3 fatty acids and fibrates, along with dietary changes, has no effect on an emergency situation. There are no clinical guidelines to SH, but therapy with insulin, heparin, a combination of both, plasmapheresis, or octreotide have been tested succesfully. We report the case of a 10-year-old girl with clinical acute pancreatitis and diabetic ketoacidosis debut, along with incidental finding of an SH, who had a good outcome after treatment with insulin intravenous infusion.
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Santana et al. (2011) studied this question.
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