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

Aldhaleei, Wafa Ali; Alnuaimi, Abdulaziz; Bhagavathula, Akshaya Srikanth

doi:10.7759/cureus.9414

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…All the case series and case reports on HTGP had described patients in their young and middle age (28–55 years), who had presented to a hospital with epigastric pain, within three days of their illness. More than 85% of the patients in these reports were males [ 5 , 6 , 9 , 10 ]. In an open-label randomized controlled trial done in China; the mean age at presentation was 41 ± 8 years (18–85), with 23% of the patients being females, and 18% being diabetics.…”

Section: Discussionmentioning

confidence: 99%

Hypertriglyceridemic pancreatitis managed with heparin and insulin: a case report

Anbessie

Gebremeskel

2023

J Med Case Reports

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Background Alcohol and gall stones are common causes of pancreatitis. Other causes of pancreatitis include hypertriglyceridemia, trauma, congenital anomalies, and medications. Hypertriglyceridemic pancreatitis is distinguished, as it is more severe and complicated. The management of hypertriglyceridemic pancreatitis, other than the basic care given to other pancreatitis patients, is to decrease the serum triglyceride level to less than 500 mg/dl as soon as possible. Plasmapheresis, hemofiltration, and other modalities have been proven effective therapies, but, are expensive and not easily accessible. Insulin and heparin which are cheaper alternatives for treatment, have been reported in case reports along with one randomized controlled trial. The number of patients in these reports was small, so, the therapy is not well established. For most African countries like ours, the only option for management is heparin and insulin. Despite this fact, there has not been any publication regarding this issue on our continent. Case report We report the case of a 24 years old Ethiopian male who presented with severe central abdominal pain, easy fatiguability, and vomiting of one-day duration. He was tachycardic and tachypneic with diffuse abdominal tenderness, and had tendon xanthomas. His plasma was lactescent with a serum triglyceride level of 4775 mg/dl. His abdominal CT scan showed diffuse pancreatic swelling with a peripancreatic fluid collection, and his serum lipase was elevated. With a diagnosis of hypertriglyceridemic pancreatitis, he was managed with intravenous insulin infusion along with subcutaneous heparin. His random blood sugar was checked hourly with three episodes of hypoglycemia during therapy. His serum triglyceride level dropped to less than 500 mg/dl in three days, and he was discharged with no complications. Conclusion Since our findings are consistent with a prior randomized controlled trial and compilation of case reports, it would strengthen the evidence for safety and efficacy of insulin and heparin therapy. This therapy, which is the only available therapy in most countries of our continent, would decrease most of the complications of hypertriglyceridemic pancreatitis that we face. We believe, our report would be a wake-up call for researchers and clinicians in our continent to change their practice and strengthen the evidence for the treatment.

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Section: Discussionmentioning

confidence: 99%

Hypertriglyceridemic pancreatitis managed with heparin and insulin: a case report

Anbessie

Gebremeskel

2023

J Med Case Reports

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“…For instance, dimethylamine and trimethylamine appear in patients suffering from end-stage renal disease, 208 nitric oxide is a gas marker of asthma, 209 acetone is connected with diabetes, 210 ammonia is related to hepatitis, 210 etc. Furthermore, as a result of the spread of the pandemic, because of the time required for PCR testing and the potential for error in rapid antigen detection, many scientists have attempted to analyse and diagnose Covid-19 by breath samples, 211,212 for example, Aldhaleei et al 213 indicated that patients with Covid-19 may have relatively higher levels of ammonia in their expiratory volumes. In addition to the diagnosis of the disease, the testing of alcohol content of breathed out gas also plays an important role in identifying drunk drivers in daily life.…”

Section: Applications Of Self-powered Biosensorsmentioning

confidence: 99%

Self-powered sensors for biomarker detection

Yang

et al. 2023

Sens. Diagn.

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“…The results of this study were upper than those of (Qian et al, 2020) who found 7 (7.69%), 9 (9.8%), and slightly decreased than (Wan et al, 2020) who found elevated AST, and ALT percentages results were 25%. Increased level of TSB accepted (Aldhaleei et al, 2020). Some theories contend that liver damage in COVID-19 individuals may originate from the virus itself or from extra details including medication toxicity and systemic inflammation (Yang et al, 2020).…”

Section: Liver Function Test For Covid-19mentioning

confidence: 99%

The Effect of Covid-19 on Liver

Ali

Mahmood²,

Dheeb³

2022

Egyptian Academic Journal of Biological Sciences, G. Microbiolo

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revealed the discovery of the first case of respiratory illness brought on by a novel coronavirus. The World Health Organization named the disorder coronavirus disease 2019 (COVID-19) dated February 11, 2020, despite the fact that it is still dangerous throughout the entire world (CDC, 2020). As SARS-CoV-2 infected the liver and cause dysfunction and damage to hepatocytes (Fan et al., 2020). Symptoms included cough, fever, pneumonia, ‫و‬headache, diarrhea, hemoptysis, and, dyspnea, (Adhikari et al., 2020).SARS-CoV-2 uses the host receptor angiotensin I converting enzyme 2 (ACE2) to infect human cells. Even though it has been claimed that ACE2 is expressed in the lung, liver, stomach, ileum, kidney, and colon, these tissues actually express it at relatively low levels, particularly in the lung) Qi et al., 2020;Lai et al., 2020).When a disease is present, the innate immune system starts to react. Some innate immune cytokines increase, which may help in predicting the subsequent stages of the clinical period (Mason, 2020;Liu et al., 2020). Cytokine storms, which come from increased levels of proinflammatory cytokines and chemokines that affect numerous organs, are the cause of ARDS in COVID-19 disease Merad and Martin, 2020). In the host cell, the type transmembrane protease, serine 2 (TMPRSS2) increases viral uptake by cleaving ACE2 and activating the SARS-CoV-2 S protein, which enables coronavirus entrance into host cells (Hoffmann et al., 2020). ACE2 and TMPRSS2 are present in target cells of the host, specifically alveolar epithelial type II cells (Mancia et al., 2020; Zou et al., 2020).

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

Cited by 4 publications

References 13 publications

Hypertriglyceridemic pancreatitis managed with heparin and insulin: a case report

Hypertriglyceridemic pancreatitis managed with heparin and insulin: a case report

Self-powered sensors for biomarker detection

The Effect of Covid-19 on Liver

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