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hypertriglyceridemia, pancreatitis

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https://www.readbyqxmd.com/read/28725307/acute-pancreatitis-secondary-to-severe-hypertriglyceridemia-management-of-severe-hypertriglyceridemia-in-emergency-setting
#1
Ahmad Chaudhary, Umair Iqbal, Hafsa Anwar, Hafiz Umair Siddiqui, Madiha Alvi
Hypertriglyceridemia (HTG) is the third most common cause of acute pancreatitis (AP). The incidence of AP is around 10-20% with levels > 2,000 mg/dL. We present here a case of a 44-year-old male with history of uncontrolled diabetes mellitus and HTG admitted with severe abdominal pain. Labs revealed elevated lipase and amylase. CT of abdomen with contrast showed AP. He was found to have a triglyceride (TG) level of 6,672 mg/dL. Besides conventional treatment for AP with intravenous (IV) hydration, he was started on IV regular insulin along with dextrose saline...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28719397/obesity-and-pancreatitis
#2
Biswajit Khatua, Bara El-Kurdi, Vijay P Singh
PURPOSE OF REVIEW: The obesity pandemic poses a unique set of problems for acute pancreatitis - both by increasing acute pancreatitis incidence, and worsening acute pancreatitis severity. This review explores these associations, underlying mechanisms, and potential therapies. RECENT FINDINGS: We review how the obesity associated increase in gallstones, surgical, and endoscopic interventions for obesity management, diabetes, and related medications such as incretin-based therapies and hypertriglyceridemia may increase the incidence of acute pancreatitis...
July 17, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28697142/plasmapheresis-for-hypertriglyceridemia-induced-acute-pancreatitis-in-a-child-a-case-report-and-brief-review-of-the-literature
#3
Ke-You Zhang, Kenneth L Cox, Zachary M Sellers
No abstract text is available yet for this article.
August 2017: Pancreas
https://www.readbyqxmd.com/read/28682990/elevated-serum-triglycerides-in-the-prognostic-assessment-of-acute-pancreatitis-a-systematic-review-and-meta-analysis-of-observational-studies
#4
Qian Wang, Gang Wang, Zhaoyan Qiu, Xianli He, Chaoxu Liu
BACKGROUND: Hypertriglyceridemia has been positively associated with the risk of acute pancreatitis (AP), but whether increased triglyceride (TG) levels are associated with the severity of AP remains unknown. To this, a meta-analysis was conducted to assess the effect of elevated serum TG on the prognosis of AP. METHODS: We searched PubMed, EMBASE, and the Cochrane library to identify all eligible studies (up to September 2016). We pooled the odds ratios (ORs) or standardized mean difference from individual studies using a random-effects model to investigate associations between levels of TG and the prognosis of AP...
August 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28670087/plasmapheresis-for-recurrent-acute-pancreatitis-from-hypertriglyceridemia
#5
Kathleen Kopecky, Amber Moreland, Christopher Hebert, Gates B Colbert
Acute pancreatitis is a known complication of severe hypertriglyceridemia. Therapeutic experience with plasmapheresis is less well reported but has been highly successful in life-threatening presentations. We describe a 38-year-old obese Hispanic woman with a previous history of acute pancreatitis from diabetic hypertriglyceridemia who presented to the emergency department with a 2-day history of worsening abdominal pain. Plasmapheresis was initiated with one calculated plasma volume exchange using 5% albumin replacement within 24 hours of admission...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28669686/pharmacologic-approaches-for-the-management-of-patients-with-moderately-elevated-triglycerides-150-499-mg-dl
#6
REVIEW
Michael S Kelly, Craig Beavers, John D Bucheit, Evan M Sisson, Dave L Dixon
Hypertriglyceridemia, defined as serum triglyceride (TG) levels >150 mg/dL, now affects over one-quarter of the US adult population and is associated with an increased risk of atherosclerotic cardiovascular disease. Available guidelines for managing hypertriglyceridemia vary with respect to TG thresholds and severity of disease. Lifestyle modifications and management of secondary causes (eg, diabetes) remain the first step in managing hypertriglyceridemia, with pharmacotherapy reserved to reduce the risk of pancreatitis and/or further reduce TG levels...
June 6, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28655321/stratified-analysis-and-clinical-significance-of-elevated-serum-triglyceride-levels-in-early-acute-pancreatitis-a-retrospective-study
#7
Jianhua Wan, Wenhua He, Yin Zhu, Yong Zhu, Hao Zeng, Pi Liu, Liang Xia, Nonghua Lu
BACKGROUND: Hypertriglyceridemia is one of the three most common causes of AP, which is associated with the AP prognosis that has not been clearly defined. METHODS: In this retrospective study, 1539 AP patients, who had serum triglyceride (TG) levels measured within the first 72 h, were assessed. The study groups consisted of patients with normal, mild, moderate, and severe/very severe HTG levels based on the Endocrine Society Clinical Practice Guidelines. We collected baseline demographic information, laboratory values, complications, and clinical outcome data in different HTG severity groups to analyze the clinical significance of elevated TG levels in AP...
June 27, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28647101/the-role-of-hypertriglyceridemia-for-acute-kidney-injury-in-the-course-of-acute-pancreatitis-and-an-animal-model
#8
Congye Wu, Lei Zou, Shujing Shi, Zhihui Tong, Xiao Shen, Dongliang Yang, Lu Ke, Weiqin Li, Jieshou Li
OBJECTIVE: The aim of this study was to investigate the role of hypertriglyceridemia for acute kidney injury (AKI) in the course of acute pancreatitis. METHODS: Patients with acute pancreatitis were retrospectively divided into four groups according to admission triglyceride: normal group, mild HTG group, moderate HTG group and severe HTG group. Clinical characteristics were compared among these groups. Wild type (WT) mice and Human ApoC III transgenic (ApoCIIItg) mice were used in the next animal experiments...
June 12, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28636207/specificity-of-and-influence-of-hemolysis-lipemia-and-icterus-on-serum-lipase-activity-as-measured-by-the-v-lip-p-slide
#9
Joerg M Steiner, Robynne Gomez, Jan S Suchodolski, Jonathan A Lidbury
BACKGROUND: Measurement of pancreatic lipase in serum is being used for the diagnosis of pancreatitis. OBJECTIVES: The aims of this study were to measure serum lipase activity by the v-LIP-P slide and serum canine pancreatic lipase immunoreactivity (cPLI) concentration by Spec cPL in dogs with exocrine pancreatic insufficiency (EPI) and in serum samples that were hemolyzed, lipemic, or icteric. METHODS: Serum samples from 50 dogs with EPI, 8 samples spiked with canine hemoglobin, Intralipid, or ditaurobilirubin, and 8 samples from dogs with severe hypertriglyceridemia were evaluated using v-LIP-P and Spec cPL assays...
June 21, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28630246/ominous-triad-triggered-by-high-dose-glucocorticosteroid-therapy
#10
Sarah Bär, Fritz Daudel, Thomas Zueger
Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28606150/severe-hypertriglyceridemia-in-norway-prevalence-clinical-and-genetic-characteristics
#11
Kjetil Retterstøl, Ingunn Narverud, Randi Selmer, Knut E Berge, Ingvild V Osnes, Stine M Ulven, Bente Halvorsen, Pål Aukrust, Kirsten B Holven, Per O Iversen
BACKGROUND: There is a lack of comprehensive patient-datasets regarding prevalence of severe hypertriglyceridemia (sHTG; triglycerides ≥10 mmol/L), frequency of co-morbidities, gene mutations, and gene characterization in sHTG. Using large surveys combined with detailed analysis of sub-cohorts of sHTG patients, we here sought to address these issues. METHODS: We used data from several large Norwegian surveys that included 681,990 subjects, to estimate the prevalence...
June 12, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28595549/apoc-iii-antisense-oligonucleotides-a-new-option-for-the-treatment-of-hypertriglyceridemia
#12
Joel Schmitz, Ioanna Gouni-Berthold
Elevated triglyceride levels (higher than ~1000 mg/dL) are associated with an increased risk for pancreatitis. Apolipoprotein-CIII (apoC-III) plays a key role in the metabolism of triglycerides and triglyceride-rich lipoproteins. Loss of function mutations in the gene encoding apoC-III (APOC3) are associated with low triglyceride levels and a decreased risk for cardiovascular disease (CVD) while overexpression of APOC3 is associated with hypertriglyceridemia. Although many drugs such as fibrates, statins and omega-3 fatty acids modestly decrease triglyceride levels (and apoC-III concentrations), there are many patients who still have severe hypertriglyceridemia and are at increased risk for pancreatitis and potentially for CVD...
June 8, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28577287/lipemic-serum-in-hypertriglyceridemia-induced-pancreatitis
#13
Michael A Santos, Nisarg B Patel, Carolina Correa
No abstract text is available yet for this article.
June 2, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28559780/pancreatitis-induced-by-cocaine
#14
Sebastián Pablo Chapela, Silvina de Los Angeles Paz, Florencia Maria Ballestero
Pancreatitis is one of the commonest diseases of the gastrointestinal tract, characterized by epigastric pain of moderate to severe intensity, which radiates to the back, elevation of pancreatic lipase and amylase enzymes, and changes in pancreatic parenchyma in imaging methods. The most common etiologies vary, generally the most frequent being biliary lithiasis and alcohol, followed by hypertriglyceridemia. Among the less frequent causes is drug-induced pancreatitis. We report a case of acute pancreatitis caused by cocaine, rarely described in literature...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28548960/severe-hypertriglyceridemia-due-to-two-novel-loss-of-function-lipoprotein-lipase-gene-mutations-c310r-e396v-in-a-chinese-family-associated-with-recurrent-acute-pancreatitis
#15
Yu Lun, Xiaofang Sun, Ping Wang, Jingwei Chi, Xu Hou, Yangang Wang
Lipoprotein lipase (LPL) is widely expressed in skeletal muscles, cardiac muscles as well as adipose tissue and involved in the catabolism of triglyceride. Herein we have systematically characterized two novel loss-of-function mutations in LPL from a Chinese family in which afflicted members were manifested by severe hypertriglyceridemia and recurrent pancreatitis. DNA sequencing revealed that the proband was a heterozygote carrying a novel c.T928C (p.C310R) mutation in exon 6 of the LPL gene. Another member of the family was detected to be a compound heterozygote who along with the c...
May 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/28548292/hypertriglyceridemic-acute-pancreatitis-in-an-emergency-department-the-typical-clinical-features-and-genetic-variants
#16
Wan Jun Chen, Xiao Fan Sun, Rui Xue Zhang, Min Jie Xu, Tong Hai Dou, Xiao Bin Zhang, Min Zhong, Wei Qiang Yang, Li Liu, Xiao Ye Lu, Chang Qing Zhu
OBJECTIVE: To investigate the clinical characteristics of hypertriglyceridemic acute pancreatitis (HTGAP), and the molecular foundation contributing to the hypertriglyceridemia in this group of patients. METHODS: Clinical data from 329 patients with AP were collected and analyzed. All the patients were divided into 1) HTGAP group (n = 40), with fasting serum triglyceride ≥ 500 mg/dL; and 2) NHTGAP group (n = 289). Next, the targeted next-generation sequencing was applied in 11 HTGAP patients to detect the genetic mutation associated with hypertriglyceridemia that included apolipoprotein A-5 (APOA5), apolipoprotein C-3 (APOC3), apolipoprotein E (APOE), BLK proto-oncogene, lipoprotein lipase (LPL), apolipoprotein C-2 (APOC2), glycosylphosphatidylinositol anchored high density lipoprotein binding protein-1(GPIHBP1), and lipase maturation factor-1(LMF1)...
May 26, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28522995/dysbiosis-of-intestinal-microbiota-and-decreased-antimicrobial-peptide-level-in-paneth-cells-during-hypertriglyceridemia-related-acute-necrotizing-pancreatitis-in-rats
#17
Chunlan Huang, Jing Chen, Jingjing Wang, Hui Zhou, Yingying Lu, Lihong Lou, Junyuan Zheng, Ling Tian, Xingpeng Wang, Zhongwei Cao, Yue Zeng
Hypertriglyceridemia (HTG) aggravates the course of acute pancreatitis (AP). Intestinal barrier dysfunction is implicated in the pathogenesis of AP during which dysbiosis of intestinal microbiota contributes to the dysfunction in intestinal barrier. However, few studies focus on the changes in intestine during HTG-related acute necrotizing pancreatitis (ANP). Here, we investigated the changes in intestinal microbiota and Paneth cell antimicrobial peptides (AMPs) in HTG-related ANP (HANP) in rats. Rats fed a high-fat diet to induce HTG and ANP was induced by retrograde injection of 3...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28516251/-severe-hypertriglyceridemia-diagnostics-and-new-treatment-principles
#18
U Kassner, M Dippel, E Steinhagen-Thiessen
Severe hypertriglyceridemia is defined at a plasma triglyceride (TG) concentration of >885 mg/dl and may result - in particular when clinical symptoms appear before the age of 40 - from "large variant" mutations in genes which influence the function of the lipoprotein lipase (LPL). For diagnosis, secondary factors have to be excluded and treated before further genetic tests are considered. Typical symptoms in almost all patients are recurrent, sometimes severe abdominal pain attacks, which can result in acute pancreatitis, the most important, sometimes life-threatening complication...
May 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28507728/therapeutic-plasmapheresis-for-hypertriglyceridemia-associated-acute-pancreatitis-case-series-and-review-of-the-literature
#19
REVIEW
Kiran Joglekar, Ben Brannick, Dipen Kadaria, Amik Sodhi
BACKGROUND: Severe hypertriglyceridemia (HTG) is the third leading cause of acute pancreatitis (AP) in the United States. The current standard of care includes management of HTG using pharmacological therapy. More recently, plasmapheresis has been proposed as a therapeutic tool for decreasing triglyceride (TG) levels, especially in critically ill patients. Few studies are available to ascertain overall benefits of plasmapheresis over traditional management. OBJECTIVE: To analyze the outcomes of patients treated with plasmapheresis for severe HTG-associated pancreatitis...
April 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28502491/a-novel-frameshift-mutation-in-the-lipoprotein-lipase-gene-is-rescued-by-alternative-messenger-rna-splicing
#20
Andrew D Laurie, Campbell V Kyle
BACKGROUND: Type I hyperlipoproteinemia, manifesting as chylomicronemia and severe hypertriglyceridemia, is a rare autosomal recessive disorder usually caused by mutations in the lipoprotein lipase gene (LPL). OBJECTIVE: We sought to determine whether mutations in LPL could explain the clinical indications of a patient presenting with pancreatitis and hypertriglyceridemia. METHODS: Coding regions of LPL were amplified by polymerase chain reaction and analyzed by nucleotide sequencing...
March 2017: Journal of Clinical Lipidology
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