What is the clinical evidence from this study?

Study design: Case Report. Population: Hypertriglyceridemia-induced Pancreatitis and ALI/ARDS (n=1). Intervention: Plasmapheresis.

What question did this study set out to answer?

To explore the association between hypertriglyceridemia-induced pancreatitis and the progression to acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).

May 20, 2026

C48-36 Hypertriglyceridemia-induced Pancreatitis as a Cause of ALI /ARDS

Key Result

Plasmapheresis successfully treated hypertriglyceridemia-induced acute severe pancreatitis complicated by ARDS in a 27-year-old male, reducing triglycerides from 2,326 to 292.

Key Points

To explore the association between hypertriglyceridemia-induced pancreatitis and the progression to acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).
Case study of a 27-year-old male with a medical history of Type 1 diabetes and hypertriglyceridemia.
Monitoring of triglyceride levels, implementation of plasmapheresis, and assessment of respiratory function during hospitalization.
Data collection from CT scans, lab results, and clinical observation during the patient's admission.
Patient demonstrated severe pancreatitis verified by CT findings with initial triglyceride levels of 1,463, which increased to 2,326.
Developed respiratory distress leading to intubation on day 2 despite management of diabetic ketoacidosis.
After plasmapheresis, patient's triglycerides decreased to 292 upon discharge, while respiratory function improved, allowing extubation on day 8.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

1 27-year-old male with Type 1 diabetes mellitus and hypertriglyceridemia presenting with acute severe pancreatitis, diabetic ketoacidosis, and developing ARDS.

Intervention

Plasmapheresis (3 sessions) with a target of <500, alongside fluids and insulin drip.

Outcome

Reduction in triglyceride levels and improvement in respiratory function (extubation).

Prompt treatment with plasmapheresis may be effective in managing hypertriglyceridemia-induced pancreatitis that progresses to ARDS.

Abstract

Abstract Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are known complications of systemic infections, aspiration, trauma, shock, etc. Pancreatitis is a known cause, and it is very important to identify all causes including hypertriglyceridemia as it is a treatable risk factor. A 27-year-old male with a past medical history of Type 1 diabetes mellitus and hypertriglyceridemia presented to the hospital with abdominal pain, nausea and vomiting for 2 days. On review of his history, he was admitted three months earlier to the intensive care unit, placed on insulin drip to control his severely elevated triglyceride levels (4,000). He admitted to noncompliance with insulin and has been working with his PCP to get an insulin pump. He was not taking any other medications. Examination was remarkable for severe dehydration and abdominal tenderness. CT abdomen revealed findings of acute severe pancreatitis. He was found to be in diabetic ketoacidosis (Beta Hydroxybutyrate 4.31, Glu 644, Agap 18, HCO3 12) and was started on fluids and insulin drip. His labs also showed hypocalcemia (5.9) and kidney injury (Cr 1.55). Initial triglycerides were 1,463, increasing to 2,326 the next day. He went into respiratory distress despite improvement in DKA and closure of Agap, concerning for developing ARDS. He was intubated on the 2nd day of admission and put on high PEEP. Nephrology was consulted and plasmapheresis was started with target 500. His TGs were monitored, and he eventually received 3 sessions during admission (292 on discharge). His respiratory function continued to improve, and he was extubated on day 8 and remained on low oxygen requirements. He was discharged on day 15 and instructed to take Pravastatin, Niacin, Fenofibrate and insulin. This case demonstrates the significance of assessing patients with pancreatitis for hypertriglyceridemia as it may indicate progression to ALI/ARDS and the need to treat it promptly with plasmapheresis. There has been a study linking the triglyceride glucose index and the risk of acute respiratory failure in patients with acute pancreatitis. This abstract is funded by: None

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