Key result
A single session of plasma exchange combined with IV insulin successfully reduced serum triglycerides to less than 1000 mg/dl and resolved systemic inflammatory symptoms in a patient with hypertriglyceridemia-induced acute pancreatitis.
Why the study?
Hypertriglyceridemia induced pancreatitis is becoming more common and severe, yet clinicians face dilemmas regarding management given variable treatment options, procedural invasiveness, and a paucity of evidence.
Case Report (n=1)
No
This case report highlights the clinical dilemma in managing hypertriglyceridemia-induced acute pancreatitis given the variety of treatment options and paucity of evidence.
Does not support practice change after one case; leaves open whether plasma exchange plus insulin improves outcomes in hypertriglyceridemic pancreatitis.
Acute pancreatitis results in high morbidity and mortality. Gallstones and alcoholism are considered leading causes of acute pancreatitis. However, increasing prevalence of obesity, diabetes and lifestyle choices has resulted in Hypertriglyceridemia induced pancreatitis (HTAP) becoming more common. HTAP is said to be more severe than other causes. The treatment options available vary including intravenous (IV) insulin, heparin, plasma exchange, fibrates, niacin, omega three fatty acids and dietary restrictions. This is a case report of a patient presenting with HTAP and the dilemma treating physicians faced in trying to balance the need for urgent treatment with invasiveness of procedure and paucity of evidence. Keywords: Hypertriglyceridemia induced Acute pancreatitis (HTAP), Lipoprotein lipase (LPL), Triglycerides (TG). Deep vein thrombosis (DVT), Systemic inflammatory response syndrome (SIRS), Hypertriglyceridemia (HTG), Infusions, Intravenous (IV).
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Mufti et al. (2023) conducted a case report in Hypertriglyceridemia-induced acute pancreatitis (n=1). Plasma exchange and IV insulin was evaluated on Serum triglyceride levels and symptomatic improvement. A single session of plasma exchange combined with IV insulin successfully reduced serum triglycerides to less than 1000 mg/dl and resolved systemic inflammatory symptoms in a patient with hypertriglyceridemia-induced acute pancreatitis.
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