Role of mean platelet volume in hypertriglyceridemia-induced acute pancreatitis during pregnancy

Abstract

Background Hypertriglyceridemia-induced acute pancreatitis during pregnancy (HTG-APP) is a rare but severe disease with high maternal-fetal mortality risk, which constitutes a systemic inflammatory process accompanied by thrombosis and bleeding disorders. However, the role of mean platelet volume (MPV) in HTG-APP remains unclear. Methods In the retrospective study, we collected 45 patients with HTG-APP as the HTG-APP group and 49 pregnant females with hypertriglyceridemia as the control group. MPV and other relevant variables at onset and remission were collected and compared. Results MPV were significantly higher in the HTG-APP group than in the control group (P < 0.001), and lower in remission than on onset (P = 0.002). According to the severity of acute pancreatitis, all subjects were classified into mild AP (MAP), moderately severe AP (MSAP), and severe AP (SAP) groups. There was a significant difference in MPV on onset among the three groups (P = 0.048), and the SAP patients had the highest levels of MPV. In addition, only in the SAP group, MPV was lower in remission than on onset (P = 0.010). Logistic regression analyses revealed that MPV was significantly associated with SAP (odds ratio = 2.077, 95% confdence interval, 1.038–4.154; P = 0.039). Conclusions These results may indicate an important role of mean platelet volume in evaluating the severity of HTG-APP.

Predicting the dynamics of organ failure in patients with acute pancreatitis depending on the mean platelet volume

“…The study did not assess overall accuracy, sensitivity and specificity, so further multicenter randomized studies are needed to establish the relationship between elevated MPV and AP severity. Studies related to the development of respiratory failure and local complications have demonstrated that MPV >12 fL may serve as a risk factor for severe hypertriglyceridemic AP [ 29 ].…”

Multidisciplinary diagnosis and treatment of severe acute pancreatitis associated with hypertriglyceridemia in pregnancy: a case report

“…The rates of local complications and organ failure increase significantly and dose-dependently with the level of triglycerides ( 8 ). The trend of HTG-induced AP has been observed to increase with the gestational age and number of pregnancies ( 9 ). This disease constitutes a systemic inflammatory process accompanied by thrombosis, and bleeding disorders result in multiple organ dysfunction and disseminated intravascular coagulation ( 9 ).…”

“…The trend of HTG-induced AP has been observed to increase with the gestational age and number of pregnancies ( 9 ). This disease constitutes a systemic inflammatory process accompanied by thrombosis, and bleeding disorders result in multiple organ dysfunction and disseminated intravascular coagulation ( 9 ). Yang et al showed that HTG-induced AP along with a delayed diagnosis was related to a 66.7% fetal loss ( 10 ).…”

Evaluating the efficacy and timing of blood purification modalities in early-stage hyperlipidemic acute pancreatitis treatment

“…Platelet activation plays a crucial role in the occurrence and development of AP [ 80 ]. The changes in AP with different causes are inconsistent [ 81 – 83 ]. Multiple studies have indicated that platelets directly participate in the systemic inflammatory process of AP [ 80 , 81 ], and the key value of mean platelet volume (MPV) in determining the severity of AP when combined with other inflammatory markers and scoring systems has been discovered [ 81 ].…”