Therapeutic apheresis for severe hypertriglyceridemia in pregnancy

Basar, Rafet; Üzüm, Ayşe Kubat; Canbaz, Bülent; Dogansen, Sema Ciftci; Kalayoğlu-Beşışık, Sevgi; Altay-Dadin, Senem; Aral, Feríhan; Özbey, Neşe

doi:10.1007/s00404-013-2786-z

Cited by 51 publications

(43 citation statements)

References 16 publications

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“…In addition, delivery decreases intra-abdominal pressure, and thus, the treatment of the mother becomes easier (drainage and enteral nutrition), and lipid-lowering drugs can be used safely (10). Insulin, heparin, plasmapheresis, octreotide, oral antihyperlipidemic agents and omega-3 fatty acids are among the treatment modalities of acute pancreatitis (1,(3)(4)(5)(6). The target is a TG value lower than 500 mg dL -1 with these treatments (1,11).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…This could be therapeutic plasma exchange (TPE), double-membrane filtration (DMF) or selective lipoprotein apheresis (3,17). Basar et al (3) found that the plasmapheresis modality is more effective than DMF. If fresh-frozen plasma is used during plasmapheresis, allergyand transfusion-related complications are more frequently observed (16).…”

Section: Discussionmentioning

confidence: 99%

“…Case reports and series were published, including treatment methods, such as intravenous insulin and glucose, heparin and apheresis, together with restriction of feeding (3)(4)(5)(6). Successful management of HTG affects both maternal and foetal mortality.…”

Section: Introductionmentioning

confidence: 99%

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Acute Pancreatitis Due to Hypertriglyceridaemia in Pregnancy

Gök¹,

Köker²,

Kılıçaslan³

et al. 2015

Turk J Anesth Reanim

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Gebelik sırasında hypertrigliseridemiye bağlı akut pankreatit nadir fakat hem anne hem de bebek için ölümcül sonuçlara neden olabilen ciddi klinik bir tablodur. Otuz yedi yaşında 31 haftalık familial hypertrigliseridemi ve diabetes mellitusu olan gebede akut pankreatit gelişti. İntrauterin bebek ölümü gelişen hastanın gebeliği sonlandırıldı. Tedavide insülin, octreotidin yanısıra "double membrane filtration" ile plasmaferez uygulanarak trigliseritlerin hızla düşürülmesi sağlandı. Trigliserid düzeyi 24 saat sonunda 9742 mg dL -1 'den 432 mg dL -1 düzeyine geriledi. Hasta 5 gün sonra yoğun bakımdan, 32 gün sonra hastaneden sağlıklı olarak taburcu edildi. Bu yazıda gebe vakada ciddi hipertrigliserideminin başarılı tedavisi sunulmuştur.Anahtar Kelimeler: Akut pankreatit, gebelik, hypertrigliseridemi, plazmaferez Acute pancreatitis due to hypertriglyceridaemia during pregnancy is a rare but severe clinical condition that may cause fatal results for both the mother and the foetus. Acute pancreatitis developed in a 37-year-old pregnant woman with familial hypertriglyceridaemia and diabetes mellitus in the 31 st week of pregnancy. As intrauterine foetal death developed, the pregnancy of the patient was terminated. Additionally, insulin, octreotide and plasmapheresis with "double membrane filtration" were applied, and triglycerides rapidly decreased. After 24 hours, the level of triglycerides decreased from 9742 mg dL -1 to 432 mg dL -1. The patient was discharged from the intensive care unit at the end of 5 days and was discharged from the hospital after 32 days. The current article presents the successful treatment of severe hypertriglyceridaemia in a pregnant case.Keywords: Acute pancreatitis, pregnancy, hypertriglyceridaemia, plasmapheresis Abstract / Özet

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute Pancreatitis Due to Hypertriglyceridaemia in Pregnancy

Gök¹,

Köker²,

Kılıçaslan³

et al. 2015

Turk J Anesth Reanim

View full text Add to dashboard Cite

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“…7 Also plasmapheresis is an effective alternative to decrease high triglyceride levels and risk of maternal and fetal mortality. [8][9][10] Acute pancreatitis itself or associated preeclampsia-eclampsia or HELLP syndrome lead to fetal and maternal death. There is a prediction of maternal mortality as 20% and fetal mortality as 50% if HTG induced acute pancreatitis develops.…”

Section: Discussionmentioning

confidence: 99%

Hypertriglyceridemia-Induced Acute Pancreatitis During Pregnancy

Çelik¹,

ÇELİK²,

DİKMEN³

et al. 2018

JCOG

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: 26 cute pancreatitis is a sudden inflammation of the pancreas. It is related with severe complications and high mortality despite treatment. One of the most common causes of acute pancreatitis is hypertriglyceridemia (HTG). Hypertriglyceridemia is defined as triglyceride levels more than 150 mg/dl. In normal pregnancy, lipid profile can change in response to estrogen levels. But it is important to distinguish normal from abnormal rise. There are effective treatment choices during pregnancy such as dietary restriction of fat, intravenous heparin and insulin and plasmapheresis. CASE REPORTThe patient was admitted with epigastric pain, nausea and hypertension in the 31 st weeks of gestation. Fetal heart beats were present. On admission, her vital signs were normal except blood pressure which was 150/100 mmHg. She had diabetes mellitus and hepatosplenomegaly in history. Her liver function tests had increased occasionally during pregnancy. Cesarean delivery was performed and a 1375-g female infant was delivered with 1-minute Apgar score 7 and 5-minute Apgar score 9. Her laboratory studies showed hematocrit 30.6% (normal range 35-45%), white blood cell count 19.900 cells/µL (normal range 3700-10.000 cells/L), triglyceride 1108 mg/dL (normal range <150 mg/dL), amylase 252 U/L (normal range <100 U/L), lipase 1146 U/L (normal range <60 U/L), lactate dehydrogenase 3954 U/L (normal range <448 U/L) and slightly elevated liver and renal function tests. Hypertriglyceridemia-Induced Acute Pancreatitis During PregnancyA AB BS S T TR RA AC CT T Acute pancreatitis is a sudden inflammation of the pancreas. It is related with severe complications and high mortality despite treatment. One of the most common causes of acute pancreatitis is hypertriglyceridemia (HTG) that is defined as triglyceride levels more than 150 mg/dl. There are effective treatment choices during pregnancy such as dietary restriction of fat, intravenous heparin and insulin and plasmapheresis. We presented a patient with severe HTG induced pancreatitis during pregnancy. She was consulted with hypertension and epigastric pain in the 31st weeks of gestation. After birth, she was treated successfully with heparin, insulin and cessation of oral intake and total parenteral nutrition.K Ke ey yw wo or rd ds s: : Pancreatitis; hypertriglyceridemia; pre-eclampsia; pregnancy

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