Newly Diagnosed Acromegaly Presenting with Hypertriglyceridemic Pancreatitis with Normal Amylase and Lipase Levels

Abstract

The incidence of hypertriglyceridemia in acromegaly is three times higher than in the normal population, and it is the most common dyslipidemia in acromegaly. We present a case of hypertriglyceridemic pancreatitis confirmed by imaging, with normal pancreatic enzymes. Hypertriglyceridemia in this patient was likely secondary to acromegaly. The hypertriglyceridemic pancreatitis appears to be secondary to somatotrophic pituitary adenoma.

Serum lipase in acute pancreatitis associated with hypertriglyceridaemia

“…Several case reports have described normal serum lipase levels in HTG-AP. [8][9][10][11] A study of 11 patients with AP associated with diabetic ketoacidosis identified four individuals (36%) with significant hypertriglyceridaemia, two of whom had normal serum lipase levels. 12 The mechanism by which elevated triglycerides results in false lowering of serum lipase in vitro is not known.…”

Hypertriglyceridemia-induced acute pancreatitis: A prospective, multicenter, international cohort analysis of 716 acute pancreatitis cases.

“…Our data confirmed a significant reduction of amylase and lipase levels with the elevation of TG. Furthermore, case reports have been published by Singh et al [26] and Sotello et al [27], presenting HTG-AP patients with normal amylase and lipase levels.…”