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

Mosztbacher, Dóra; Hanák, Lilla; Farkas, Nelli; Szentesi, Andrea; Mikó, Alexandra; Bajor, Judit; Patrícia, Silvia; Czimmer, József; Vincze, Áron; Hegyi, Péter; Takács, Tamás; Czakó, László; Németh, Balázs Csaba; Izbéki, Ferenc; Halász, Adrienn; Gajdán, László; Hamvas, József; Papp, Mária; Földi, Ildikó; Fehér, Krisztina; Varga, Márta; Csefkó, K; Török, Imola; Farkas, Hunor; Mickevičius, Artautas; Maldonado, Elena Ramirez; Sallinen, Ville; Novák, Jan; İnce, Ali Tüzün; Galeev, Shamil; Bod, Barnabás; Sümegi, János; Pěnčík, Petr; Dubravcsik, Zsolt; Illés, Dóra; Gódi, Szilárd; Kui, Balázs; Korbonits, M; Pécsi, Dániel; Varjú, Péter; Darvasi, Erika; Párniczky, Andrea

doi:10.1016/j.pan.2020.03.018

Cited by 85 publications

(74 citation statements)

References 38 publications

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“…Hypertriglyceridemia is the third most common cause of pancreatitis and is responsible for more than 15% of the cases. Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) accounts for 1% to 5% of AP cases [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Prognostic Factors of Severity in Acute Biliary Pancreatitis

Silva-Vaz

Abrantes

Castelo‐Branco

et al. 2020

IJMS

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Acute pancreatitis (AP) is an inflammatory disorder of the pancreas that, when classified as severe, is associated with high morbidity and mortality. Promptly identifying the severity of AP is of extreme importance for improving clinical outcomes. The aim of this study was to compare the prognostic value of serological biomarkers, ratios, and multifactorial scores in patients with acute biliary pancreatitis and to identify the best predictors. In this observational and prospective study, the biomarkers, ratios and multifactorial scores were evaluated on admission and at 48 h of the symptom onset. On admission, regarding the AP severity, the white blood count (WBC) and neutrophil–lymphocyte ratio (NLR), and regarding the mortality, the WBC and the modified Marshall score (MMS) showed the best predictive values. At 48 h, regarding the AP severity, the hepcidin, NLR, systemic inflammatory response index (SIRI) and MMS and regarding the mortality, the NLR, hepcidin and the bedside index for severity in AP (BISAP) score, showed the best predictive values. The present study enabled the identification, for the first time, of SIRI as a new prognostic tool for AP severity, and validated hepcidin and the NLR as better prognostic markers than C-reactive protein (CRP) at 48 h of symptom onset.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Prognostic Factors of Severity in Acute Biliary Pancreatitis

Silva-Vaz

Abrantes

Castelo‐Branco

et al. 2020

IJMS

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“…Viral infections such as mumps, Coxsackie, hepatitis, and herpes viruses are known causes of pancreatitis[ 5 ]. There is a strong possibility that, like other, less common causes of acute pancreatitis (AP), infectious etiology is underdiagnosed on account of the insufficient workup of idiopathic cases and cases where an apparent cause ( e.g., alcohol consumption) is already established[ 6 - 8 ].…”

Section: Introductionmentioning

confidence: 99%

Insufficient etiological workup of COVID-19-associated acute pancreatitis: A systematic review

Juhász¹,

Ocskay²,

Kiss³

et al. 2020

WJG

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BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, mostly causing respiratory symptoms, is also known to affect the gastrointestinal tract. Several case reports hypothesize that SARS-CoV-2 could be an etiological factor in acute pancreatitis (AP). AIM To assess all the available evidence in the literature relating to coronavirus disease 2019 (COVID-19) and AP. METHODS We performed a systematic review of the available literature on the topic. The systematic search was conducted on 15 May 2020 on MEDLINE, EMBASE, CENTRAL, Web of Science and Scopus with a search key using the terms “amylase,” “lipase,” “pancr*,” “COVID-19” and synonyms. Due to the low quality and poor comparability of the studies, a meta-analysis was not performed. RESULTS Six case reports and two retrospective cohorts were included, containing data on eleven COVID-19 patients with AP. Five patients had AP according to the Atlanta classification. Other publications did not provide sufficient information on the diagnostic criteria. Most cases were considered SARS-CoV-2-induced, while several established etiological factors were not investigated. We were able to identify other possible causes in most of them. CONCLUSION We strongly highlight the need for adherence to the guidelines during a diagnostic and etiological workup, which could alter therapy.

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“…A case report published by Gan et al presented an HTG-AP patient with a TG level of 3410 mg/dl and lipase of 754 IU/L [ 9 ]. A recent cohort study on 716 AP patients found that the risk of severe AP was strongly associated with TG levels over 2000 mg/dl [ 10 ]. In these patients with high TG levels, over 3543 mg/dl, most are treated with plasmapheresis or glucose-heparin-insulin (GLU-HEP-INS) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Hypertriglyceridemia–Induced Acute Pancreatitis in a Patient With Type 2 Diabetes Mellitus

Aldhaleei¹,

Alnuaimi²,

Bhagavathula³

2020

Cureus

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Acute pancreatitis (AP) is an uncommon potential complication of severe hypertriglyceridemia (HTG). We reported a case of a 45-year-old man admitted with HTG-induced AP (HTG-AP). The patient was a known diabetic (glycated hemoglobin levels: 9.5%), his triglycerides level was 3587.2 mg/dl, and the lipase level was 242 IU/L. A CT scan revealed AP. The patient was treated with a low-dose insulin infusion (0.05 unit/kg/hr) with dextrose for six days. His triglycerides came down to 673.1 mg/dl, and he was discharged. Further investigations are needed to understand the efficacy of low-dose insulin in the management of HTG-AP.

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

Cited by 85 publications

References 38 publications

Evaluation of Prognostic Factors of Severity in Acute Biliary Pancreatitis

Evaluation of Prognostic Factors of Severity in Acute Biliary Pancreatitis

Insufficient etiological workup of COVID-19-associated acute pancreatitis: A systematic review

Hypertriglyceridemia–Induced Acute Pancreatitis in a Patient With Type 2 Diabetes Mellitus

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