Secondary hypertriglyceridemia causing recurrent acute pancreatitis with normal pancreatic enzymes

Abstract

Hypertriglyceridemia (HTG) is the third leading cause of acute pancreatitis (APs) worldwide which is invariably associated with elevated pancreatic enzyme levels. We present a case of HTG-induced recurrent AP with normal serum amylase and lipase levels in a patient of Syndrome Z.

Recurrent seasonal severe hypertriglyceridemia-induced acute pancreatitis; a case report

“…Usually, HTG-AP is single episodic, and recurrent HTG-AP is considered uncommon [ 18 ]. In a study by Yan et al a total of 206 HTG-AP patients were studied.…”

“…Some studies have tried to detect minimum and peak values of serum TG levels according to seasonal variation; however, these studies have yielded contradicting results [ 10 ]. Most cases of recurrent HTG-AP found in the literature are not annual and have occurred randomly throughout the years, and no association between the reoccurrence and the seasons has been pointed out [ 5 , 9 , 18 , 19 ]. The case in the current study is associated with recurrent HTG-AP that occurred annually for the last three years in winter-autumn.…”

Interpretation of serum pancreatic enzymes in pancreatic and nonpancreatic conditions

“…Delayed testing because of late presentation may result in normal amylase levels in 19-32% patients with acute pancreatitis [60]. Moreover, the amylase levels can be normal in hypertriglyceridemia-induced acute pancreatitis or recurrent alcoholic pancreatitis; in these cases, lipase has been found to be a more accurate indicator of acute pancreatitis [61,62].…”