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hypertriglyceridemia, pancreatitis

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https://www.readbyqxmd.com/read/29923163/hypertriglyceridemia-induced-pancreatitis-updated-review-of-current-treatment-and-preventive-strategies
#1
REVIEW
Prashanth Rawla, Tagore Sunkara, Krishna Chaitanya Thandra, Vinaya Gaduputi
Hypertriglyceridemia (HTG) is an uncommon but well-established cause of acute pancreatitis (AP) comprising up to 7% of the cases. The clinical course of HTG-induced pancreatitis (HTGP) is highly similar to that of AP of other etiologies with HTG being the only distinguishing clinical feature. However, HTGP is often correlated with higher severity and elevated complication rate. At present, no approved treatment guideline for the management of HTGP is available, although different treatment modalities such as insulin, heparin, fibric acids, and omega 3 fatty acids have been successfully implemented to reduce serum triglycerides (TG)...
June 19, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29921298/compound-but-non-linked-heterozygous-p-w14x-and-p-l279-v-lpl-gene-mutations-in-a-chinese-patient-with-long-term-severe-hypertriglyceridemia-and-recurrent-acute-pancreatitis
#2
Xiaoyao Li, Qi Yang, Xiaolei Shi, Weiwei Chen, Na Pu, Weiqin Li, Jieshou Li
BACKGROUND: Variants in the lipoprotein lipase (LPL), apolipoprotein C-II (APOC2), apolipoprotein A-V (APOA5), GPIHBP1 and LMF1 genes may cause severe hypertriglyceridemia (HTG), which is now the second-leading aetiology of acute pancreatitis in China. METHODS: The patient and his family were assessed for gene variants by Sanger sequencing of exons and exon-intron junctions of the LPL, GPIHBP1, APOA5, APOC2, and LMF1 genes. Post-heparin blood was collected for LPL mass and activity detection...
June 19, 2018: Lipids in Health and Disease
https://www.readbyqxmd.com/read/29915775/severe-hypertriglyceridemia-presenting-as-eruptive-xanthomatosis
#3
Sameera S Vangara, Kyle D Klingbeil, Raymond M Fertig, Jason L Radick
Eruptive xanthomatosis is described as the sudden eruption of erythematous yellow papules in the presence of hypertriglyceridemia, often associated with serum triglyceride levels above 2000 mg/dl. Severe hypertriglyceridemia can be caused by primary genetic mutations, secondary chronic diseases, or a combination of both. Uncontrolled diabetes mellitus is a known risk factor. It is imperative for physicians to be aware of eruptive xanthomatosis as a warning sign for severe hypertriglyceridemia due to the underlying risk for the potentially fatal complication of acute pancreatitis...
January 2018: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29914404/significantly-different-clinical-features-between-hypertriglyceridemia-and-biliary-acute-pancreatitis-a-retrospective-study-of-730-patients-from-a-tertiary-center
#4
Xiaoyao Li, Lu Ke, Jie Dong, Bo Ye, Lei Meng, Wenjian Mao, Qi Yang, Weiqin Li, Jieshou Li
BACKGROUND: Unlike western world, gallstones and hypertriglyceridemia (HTG) are among the first two etiologies of acute pancreatitis (AP) in China. But yet, detailed differences in clinical features and outcomes between hypertriglyceridemia and biliary acute pancreatitis have not been well described. METHODS: This retrospective study enrolled 730 acute pancreatitis patients from July 1, 2013 to October 1, 2016 in Jinling Hospital. The causes of the study patients were defined according to specific diagnostic criteria...
June 19, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29911757/reduction-in-serum-triglyceride-levels-in-diabetic-patients-may-result-in-decreased-insulin-dependence-and-disease-regression
#5
Nadav Shinhar, Dana Marcoviciu, Dror Dicker
BACKGROUND: Type 2 diabetes mellitus is a multifactorial disease in which genetic susceptibility and environmental factors induce pancreatic β-cell dysfunction and insulin resistance. Additional factors such as hyperglycemia and hyperlipidemia have roles in β-cell dysfunction and disease progression. The phenomenon of lipid-induced pancreatic β-dysfunction, designated as lipotoxicity, has been observed in several in vitro and in vivo experiments; however, there is still no solid evidence for the occurrence of this event in humans...
June 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29910554/secondary-hypertriglyceridemia-causing-recurrent-acute-pancreatitis-with-normal-pancreatic-enzymes
#6
Prabhat Kumar, Anindya Ghosh, Nitin Sinha, Rajinder Singh Tonk
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.
May 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29904289/identifying-suspected-familial-chylomicronemia-syndrome
#7
Ronak Rengarajan, Peter A McCullough, Anima Chowdhury, Kristen M Tecson
Familial chylomicronemia syndrome (FCS) is a rare lipid disorder posing significant clinical burdens on patients. Due to its rarity, variety of presentations, and lack of universal diagnostic criteria, patients see an average of five physicians before diagnosis. We screened adults for a triglyceride level ≥1000 mg/dL from September 2015 to September 2016 and a history of pancreatitis and performed a thorough chart review on those who met the criteria. An adjudication panel used a definition that also called for supportive information including history of hypertriglyceridemia or family history of pancreatitis/hypertriglyceridemia...
July 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29902156/hypertriglyceridemia-thalassemia-syndrome
#8
Mili Jain, Wahid Ali, Brijendra Bahadur Singh, Nishant Verma, Ashutosh Kumar
BACKGROUND: Hypertriglyceridemia thalassemia syndrome is a rare entity with an unknown pathogenetic link. CASE PRESENTATION: We report a case of an 8-month-old female with thalassemia major and increased triglyceride (TG) levels. The clinical features were as in classical thalassemia except for a white discoloration of the plasma. After exclusion of familial triglyceridemia and secondary causes (hypothyroidism, nephrotic syndrome, drugs etc.), a diagnosis of hypertriglyceridemia thalassemia syndrome was made...
June 14, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29876048/dilated-cardiomyopathy-secondary-to-acute-pancreatitis-caused-by-hypertriglyceridemia
#9
Jordan W Greer, William C Beck, Avi Bhavaraju, Ben Davis, Mary K Kimbrough, Joseph Jensen, Anna Privratsky, Ronald Robertson, John R Taylor, Kevin W Sexton
A 30-year-old male presented to an outside facility with acute pancreatitis and triglycerides of 1594. He was transferred to our facility after becoming febrile, hypoxic and in acute renal failure with triglycerides of 4243. CT scan performed showed wall-off pancreatic necrosis. He underwent continuous renal replacement therapy and his acute renal failure resolved. He was treated with broad spectrum antibiotics and discharged. He developed a fever to 101 a week later and was found to have a large infected pancreatic pseudocyst...
May 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29864067/pancreas-divisum-in-pediatric-acute-recurrent-and-chronic-pancreatitis-report-from-insppire
#10
Tom K Lin, Maisam Abu-El-Haija, Jaimie D Nathan, Joseph P Palermo, Bradley Barth, Melena Bellin, Douglas S Fishman, Steven D Freedman, Cheryl E Gariepy, Matthew J Giefer, Tanja Gonska, Melvin B Heyman, Ryan Himes, Sohail Z Husain, Quin Liu, Asim Maqbool, Maria Mascarenhas, Brian McFerron, Veronique D Morinville, Chee Y Ooi, Emily Perito, John F Pohl, Sue Rhee, Sarah Jane Schwarzenberg, Uzma Shah, David Troendle, Steven L Werlin, Michael Wilschanski, M Bridget Zimmerman, Mark E Lowe, Aliye Uc
INTRODUCTION: The significance of pancreas divisum (PD) as a risk factor for pancreatitis is controversial. We analyzed the characteristics of children with PD associated with acute recurrent or chronic pancreatitis to better understand its impact. PATIENTS AND METHODS: We compared children with or without PD in the well-phenotyped INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) cohort. Differences were analyzed using 2-sample t test or Wilcoxon rank sum test for continuous variables, Pearson χ or Fisher exact test for categorical variables...
June 2, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29842811/pharmacological-treatment-options-for-severe-hypertriglyceridemia-and-familial-chylomicronemia-syndrome
#11
Rabia Chaudry, Adie Viljoen, Anthony S Wierzbicki
A spectrum of disorders, ranging from rare severe cases of homozygous null lipoprotein lipase deficiency (LPLD) -familial chylomicronemia syndrome (FCS) to heterozygous missense LPLD or polygenic causes, result in hypertriglyceridemia and pancreatitis. The effects of mutations are exacerbated by environmental factors such as diet, pregnancy and insulin resistance. Areas covered: In this review, authors discuss chronic treatment of FCS by ultra-low fat diets allied with the use of fibrates, omega-3 fatty acids, niacin, statins and insulin-sensitising therapies depending on the extent of residual LPL activity; novel therapies in development target triglyceride-rich lipoprotein particle clearance...
May 29, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29804909/familial-chylomicronemia-syndrome-bringing-to-life-dietary-recommendations-throughout-the-life-span
#12
Lauren Williams, Katherine S Rhodes, Wahida Karmally, Lori A Welstead, Lori Alexander, Lindsey Sutton
BACKGROUND: Familial chylomicronemia syndrome (FCS) is a rare autosomal recessive disorder with loss of function mutations of lipoprotein lipase resulting in hypertriglyceridemia and accumulation of chylomicrons in plasma, often leading to acute pancreatitis. The mainstay of treatment is a specialized very-low-fat diet. Even adhering to the diet, some patients may experience high triglycerides and pancreatitis. There currently are no comprehensive dietary guidelines. OBJECTIVE: To report best practices and develop comprehensive dietary guidelines for nutrition therapy in patients with FCS...
April 27, 2018: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29784572/the-burden-of-familial-chylomicronemia-syndrome-results-from-the-global-in-focus-study
#13
Michael Davidson, Michael Stevenson, Andrew Hsieh, Zahid Ahmad, Jeanine Roeters van Lennep, Caroline Crowson, Joseph L Witztum
BACKGROUND: Familial chylomicronemia syndrome (FCS) is a rare genetic disorder characterized by a deficiency of lipoprotein lipase leading to extreme hypertriglyceridemia. Patients' burden of illness and quality of life have been poorly addressed in the literature. OBJECTIVE: To understand the ways in which FCS impacts patients' lives. METHODS: Investigation of Findings and Observations Captured in Burden of Illness Survey (IN-FOCUS) was a global web-based survey open to patients with FCS...
April 26, 2018: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29782195/acute-pancreatitis-secondary-to-oral-contraceptive-induced-hypertriglyceridemia-a-case-report
#14
Matheo Augusto Morandi Stumpf, Ana Claudia Garabeli Cavalli Kluthcovsky, Jefferson Matsuiti Okamoto, Gianna Carla Alberti Schrut, Patricia de Oliveira Cajoeiro, Ana Paula Marte Chacra, Ricardo Bizeli
Hypertriglyceridemia is the third most common cause of acute pancreatitis. Among the causes that lead to secondary hypertriglyceridemia, the use of contraceptive agents is the main reason to be assessed in young women. We report a case of a 31-year-old woman who had suffered two acute pancreatitis episodes secondary to hypertriglyceridemia. In the investigation, the previous medical team indicated a genetic screening before ruling out all secondary causes. LPL, apo CII and apo AV genes were negative for mutations...
May 21, 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29756955/multicenter-study-of-parenteral-nutrition-in-non-critically-ill-elderly-patients-compared-to-younger-patients-study-iaios-pn-incidence-and-assessment-of-iatrogenesis-in-older-subjects-receiving-parenteral-nutrition
#15
Javier Mateu-de Antonio, David Berlana, Montserrat Pons-Bussom, Maria B Badia-Tahull, María Teresa Miana-Mena, Beatriz Martínez-Castro, Neus Sunyer-Esquerrà, Mónica Sanmartin-Suñer, Juan González-Valdivieso, Elisabet Leiva-Badosa, Eva Martínez-Bernabé, Anna Murgadella-Sancho, Nuria Mirerachs-Aranda, Anna Vila-Bundó, Jordi Fernández-Morató, María Teresa Vitales-Farrero
OBJECTIVE: this study assessed the incidence of hyperglycemia, hypertriglyceridemia, and liver function test (LFT) alterations among patients older and younger than 65 years receiving parenteral nutrition (PN). A secondary objective was to compare the incidence of any of these three events. MATERIAL AND METHODS: inclusion criteria were non-critically ill adult inpatients receiving PN for ≥ 7 days in 15 hospitals in Spain. Exclusion criteria were hyperglycemia, hypertriglyceridemia, LFT alterations, sepsis, shock, pancreatic/hepatobiliary surgery, renal failure, diabetes mellitus (DM) type 1, insulin-treated DM type 2, acute DM complications, or obesity prior to PN...
February 27, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29745912/clinical-case-report-on-acute-pancreatitis-with-concomitant-t2dm-and-hypertriglyceridemia
#16
T Magradze, E Shelestova
Authors present a clinical case review of a 46-years-old, otherwise healthy female patient, presented with acute abdominal pain. Examination and full work-up established a diagnosis of acute pancreatitis, T2DM and hypertriglyceridemia; based on family history, inherited hypertriglyceridemia was suspected. Elevated TG values associated with diabetes dramatically increase the risk of developing MI. Subsequent to the pancreatitis treatment protocol completion, the patient has fully recovered from acute pancreatitis...
April 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29745909/a-young-adult-with-generalized-lipodystrophy-and-diabetes-mellitus-case-report
#17
E Çelo, B Kalari, F Toti
Lipodystrophies are a group of heterogeneous disorders characterized by varying degrees of body fat loss and predisposition to insulin resistance and its metabolic complications. Lipodystrophy associated metabolic abnormalities include insulin resistance, that often lead to diabetes mellitus and its complications, hypertriglyceridemia that may be severe enough to cause acute pancreatitis, and hepatic steatosis that may lead to cirrhosis. We present the case of an 18-year-old female who was hospitalized as an inaugural Diabetes Mellitus...
April 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29716801/eruptive-xanthoma-in-the-setting-of-hypertriglyceridemia-and-pancreatitis
#18
Matthew Stark, Jonathan Stuart
BACKGROUND: Undifferentiated dermatologic complaints are often encountered in the emergency department. While a patient's exposures, risk factors, and comorbidities may help guide emergency department evaluation, the accurate diagnosis of dermatologic findings is critical to allowing rapid identification and treatment of disease. CASE: In this vignette we discuss a case of eruptive xanthoma in a 33-year-old male with diabetic ketoacidosis and pancreatitis. DISCUSSION: Dermatologic complaints pose a unique challenge to the emergency physician...
April 25, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29706815/acute-pancreatitis-secondary-to-hypertriglyceridemia-precipitated-by-diabetic-ketoacidosis-in-a-previously-undiagnosed-ketosis-prone-patient-with-diabetes-mellitus
#19
Vignesh Ramachandran, Diana M Vila, John M Cochran, Andrew C Caruso, Rajeev Balchandani
Diabetic ketoacidosis is a potentially fatal complication of diabetes mellitus that may result in hypertriglyceridemia. Rarely, the resulting hypertriglyceridemia may precipitate acute pancreatitis. We report a case of acute pancreatitis secondary to hypertriglyceridemia precipitated by diabetic ketoacidosis and postulate that this unusual presentation is due to the patient being prone to ketosis.
April 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29702000/the-effect-of-intravenous-insulin-apheresis-and-oral-lipid-lowering-agents-on-non-fasting-hypertriglyceridemia-and-associated-pancreatitis
#20
Daniela Frankova, Kristin Melissa Olson, Brian Joseph Whyms, Maria Alejandra Guevara Hernandez, Jan Franko
OBJECTIVES: There is evidence that increasing severity of hypertriglyceridemia increases the risk of acute pancreatitis. There is a debate about superiority of treatment methods and previous works have specifically called for direct comparison between IV insulin and apheresis techniques. Identify patient characteristics predictive of lipid-lowering therapy selection in a large community hospital for treatment of hypertriglyceridemia; evaluate for a concentration-dependent relationship between hypertriglyceridemia severity and risk of acute pancreatitis; assess for differences in clinical outcomes between patients treated with IV insulin versus apheresis...
May 4, 2018: Postgraduate Medicine
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