Hypertriglyceridemia Induced Pancreatitis

Abstract

Objectives Hypertriglyceridemia-induced pancreatitis is an important cause of acute pancreatitis (AP) in children, which lacks established guidelines. The aim of this study was to review management approaches at a single pediatric center. Methods This retrospective study included all inpatients younger than 21 years with AP and triglycerides (TG) of 1000 mg/dL or greater. A linear mixed effect model was used to calculate drop in TGs. The patient's diet, intravenous fluid (IVF) rate, insulin, and plasmapheresis were included in the model. Results Seventeen admissions were identified among 8 patients, average age 15 years (range, 6–19 years). Fifty percent had recurrent AP and 29% of admissions had complications including 1 death. The population was primarily female (75%), white (75%), and overweight, and 63% had diabetes. The median stay was 5.4 days. There were 14 approaches used with variations in IVF rates, insulin, plasmapheresis, and nill per os (NPO) versus feeds. Variables that reduced TG's were NPO, higher IVF rates, plasmapheresis, and insulin (P < 0.05). Importantly, NPO reduced TGs faster than those who started early nutrition. Conclusions Hypertriglyceridemia is an important cause of pancreatitis in children. This study shares a management algorithm from a single institution. Larger studies are needed for more evidence-based guidelines.

Etiology and outcome of acute recurrent pancreatitis and chronic pancreatitis

“…Our study showed patients with metabolic diseases who had AP were at risk of developing ARP. Comparable to a finding in our patients, hypertriglyceridemia, particularly if the serum triglyceride level exceeds 1,000 mg/dL, is associated with pediatric ARP 29,31 . We observed that after 3 out of 4 of our patients with ARP received proper medical and nutritional management, their disease did not progress to CP.…”

“…Comparable to a finding in our patients, hypertriglyceridemia, particularly if the serum triglyceride level exceeds 1,000 mg/dL, is associated with pediatric ARP. 29,31 We observed that after 3 out of 4 of our patients with ARP received proper medical and nutritional management, their disease did not progress to CP. However, one patient developed CP as she had uncontrolled hypertriglyceridemia with a co-morbidity of end-stage renal disease, of which the latter is related to a higher incidence of pancreatitis in adults.…”

Demographics and risk factors for pediatric recurrent acute pancreatitis

“…Furthermore, they found serious complications occurred in more than 25% of their patients, including ICU stay for multiorgan failure and one death. They proposed a treatment algorithm for pediatric patients with hypertriglyceridemia-induced acute pancreatitis [31]. The precise mechanisms by which hypertriglyceridemia contributes to pancreatitis remain unclear [32].…”

Clinical Value of Hospital-Community-Family Integrated Nursing Model in the Treatment of Patients with Hyperlipidemia Pancreatitis

“…Conventionally, routine care and discharge instructions are adopted to improve patients' outcomes. 11,12 However, long-term medication, loss of treatment confidence, a negative psychological state, and low treatment compliance at home care are associated with poor treatment outcomes and reduced QoL. 13,14 In this context, the hospital-community-family nursing model has emerged.…”