Management of Acute Severe Hyperlipidemic Pancreatitis

Abstract

Background/Aim: Hypertriglyceridemia is rare and can provoke acute severe hyperlipidemic pancreatitis when triglyceride levels exceed 11.3 mmol/l. In 10 patients we evaluated the therapeutic guidelines for severe hyperlipidemic pancreatitis. Methods: Ten patients (8 men and 2 women) were admitted to the intensive care unit with a diagnosis of acute severe hyperlipidemic pancreatitis. They underwent standard treatment. Heparin, insulin and antihyperlipidemic drugs were used to lower the triglyceride levels. The patients underwent plasmapheresis within 48 h of admission, and fat-free parenteral nutrition was used. Two of the patients underwent surgery because of infection of necrotic segments. Results: Standard treatment was essential for all the patients but plasmapheresis was the procedure that lowered the triglyceride and lipid levels in all cases. It improved abdominal pain, clinical state, and signs and symptoms of the disease. Two patients underwent surgery due to infection of the necrotic segments and one of them died. Follow-up lasted 4–54 months with no recurrences of pancreatitis. Conclusion: Our study shows that standard treatment is essential, but plasmapheresis successfully lowered lipid levels with no complications and relieved the patients from the symptoms in the acute phase of the disease. Hyperlipidemic pancreatitis should initially be treated conservatively. Plasmapheresis is a method that has lately been used successfully for hyperlipidemic pancreatitis. It seems that all therapeutic measures should be applied as early as possible, within the first 48 h.

Plasmapheresis in the Management of Severe Hypertriglyceridemia

“…Several reports [25][26][27][28][29] document the successful use of TPE in treatment of hypertriglyceridemia. In some instances, TPE for hypertriglyceridemic pancreatitis resulted in improvements in clinical and laboratory findings and patient outcomes.…”

Acute hyperlipidemic pancreatitis in a pregnant woman

“…[9] Early plasmapheresis or lipid apheresis can effectively reduce serum triglyceride, inhibit disease progression, and prevent the recurrence of hyperlipidemic pancreatitis, but it has risk of acute coronary events. [10,11] Batashki et al [12] reported that intubation with artifi cial pulmonary ventilation and high volume continuous veno-venous hemofiltration (HV CVVH) should be performed because of the development of polyorgan insuffi ciency and ARDS. In our case, signs and symptoms of ARF were greatly improved after NPPV and conventional therapies, thus creating the opportunity to perform caesarean delivery when fetal distress occurred.…”

Review on Antihyperlipedemia Lipophilic Drugs and Their Novel Formulation Approaches

“…• Signs and symptoms of hyperlipidemia Hyperlipidemia usually has no noticeable symptoms and tends to be discovered during routine examination or evaluation for atherosclerotic CVD [19]. Commonly found are Xanthoma, Xanthelasma of the eyelid, Chest Pain, Abdominal Pain, Enlarged Spleen, Liver Enlarged, High cholesterol or TG levels, Heart attacks, a Higher rate of obesity and glucose intolerance, Pimple like lesions across the body, Atheromatous plaques in the arteries, Arcussenilis, Xanthomata [20].…”