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Hypertriglyceridemic Pancreatitis

Sheng-Huei Wang, Yu-Ching Chou, Wei-Chuan Shangkuan, Kuang-Yu Wei, Yu-Han Pan, Hung-Che Lin
BACKGROUND: Hypertriglyceridemia is the third most common cause of acute pancreatitis, but whether the level of triglyceride (TG) is related to severity of pancreatitis is unclear. AIM: To evaluate the effect of TG level on the severity of hypertriglyceridemic pancreatitis (HTGP). DESIGN: Retrospective cohort study. METHODS: We reviewed the records of 144 patients with HTGP from 1999 to 2013 at Tri-Service General Hospital...
2016: PloS One
W H He, Y Zhu, Y Zhu, P Liu, H Zeng, L Xia, X Huang, Y P Lei, N H Lü
OBJECTIVE: To investigate the difference in severity and clinical outcomes between hypertriglyceridemic pancreatitis (HTGP) and acute pancreatitis (AP) of other causes, and to analyze the correlation between the serum triglyceride (TG) level <24 h after onset and the disease severity. METHODS: Patients were selected from the AP database of the First Affiliated Hospital of Nanchang University, who were admitted between January 2005 and December 2013, aged ≥18 and ≤85 years, excluding pregnant or lactating women...
August 23, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Claudio Rabacchi, Sergio D'Addato, Silvia Palmisano, Tiziano Lucchi, Stefano Bertolini, Sebastiano Calandra, Patrizia Tarugi
BACKGROUND: Familial chylomicronemia is a recessive disorder that may be due to mutations in lipoprotein lipase (LPL) and in other proteins such as apolipoprotein C-II and apolipoprotein A-V (activators of LPL), GPIHBP1 (the molecular platform required for LPL activity on endothelial surface), and LMF1 (a factor required for intracellular formation of active LPL). METHODS: We sequenced the familial chylomicronemia candidate genes in 2 adult females presenting long-standing hypertriglyceridemia and a history of acute pancreatitis...
July 2016: Journal of Clinical Lipidology
Wen-Hua He, Min Yu, Yin Zhu, Liang Xia, Pi Liu, Hao Zeng, Yong Zhu, Nong-Hua Lv
OBJECTIVES: To compare the value of emergent triglyceride (TG)-lowering therapies between early high-volume hemofiltration (HVHF) and low-molecular-weight heparin (LMWH) combined with insulin (LMWH+insulin) as well as their effects on the outcomes of hypertriglyceridemic pancreatitis (HTGP) patients. METHODS: In this randomized controlled trial, 66 HTGP patients presenting within 3 days after the onset of symptoms from August 2011 to October 2013 were assigned randomly to receive either HVHF or LMWH+insulin as an emergent TG-lowering therapy...
October 2016: Journal of Clinical Gastroenterology
Rachel Lim, Sheila J Rodger, T Lee-Ann Hawkins
Pancreatitis related to hypertriglyceridemia can occasionally occur during pregnancy, particularly if there are underlying genetic abnormalities in lipid metabolism. We report the case of a 27-year-old female with hypertriglyceridemic pancreatitis in pregnancy that was treated initially with lipid lowering medications, followed by plasma exchange for persistently elevated triglyceride levels. Despite multiple interventions, she developed recurrent pancreatitis and simultaneously had a preterm birth. In this case report, we highlight the various therapies and the use of plasmapharesis in secondary prevention of hypertriglyceridemic pancreatitis in pregnancy...
December 2015: Obstetric Medicine
Stephen Melnick, Salik Nazir, David Gish, Madan Raj Aryal
We present the case of a 36-year-old woman who presented to our hospital with epigastric abdominal pain and tenderness. Laboratory evaluation identified high lipase, normal amylase, pseudohyponatremia, and relatively falsely low triglyceride levels (initial value of 2,329 mg/dl which on repeat was found to have corrected value of >10,000 mg/dl). The overall clinical picture was consistent with acute pancreatitis due to hypertriglyceridemia. The patient was commenced on IV insulin and eventually required plasmapheresis with good clinical outcome...
2016: Journal of Community Hospital Internal Medicine Perspectives
Hemant Goyal, Betsy Smith, Chelsey Bayer, Carla Rutherford, Danielle Shelnut
BACKGROUND: Alcohol and hypertriglyceridemia (HTG) are among the most common causes of acute pancreatitis (AP) after gallstones. However, differences in severity at the time of presentation and outcomes have not been well-studied. OBJECTIVE: The aim of this study is to assess the differences between severity at presentation and outcomes of AP of hypertriglyceridemic and alcoholic origins. MATERIALS AND METHODS: A retrospective review of 177 patients who were discharged with diagnosis of AP was performed...
February 2016: North American Journal of Medical Sciences
Steven L Driver, Seth S Martin, Ty J Gluckman, Julie M Clary, Roger S Blumenthal, Neil J Stone
In the 2013 American College of Cardiology (ACC)/American Heart Association Guideline (AHA) on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, low-density lipoprotein cholesterol treatment thresholds have been replaced with a focus on global risk. In this context, we re-examine the need for fasting lipid measurements in various clinical scenarios including estimating initial risk for atherosclerotic cardiovascular disease in a primary prevention patient; screening for familial lipid disorders in a patient with a strong family history of premature atherosclerotic cardiovascular disease or genetic dyslipidemia; clarifying a diagnosis of metabolic syndrome so it can be used to make lifestyle counseling more effective; assessing residual risk in a treated patient; diagnosing and treating patients with suspected hypertriglyceridemic pancreatitis; or diagnosing hypertriglyceridemia in patients who require therapy for other conditions that may further elevate triglycerides...
March 15, 2016: Journal of the American College of Cardiology
Wei-Ping Tai, Xiang-Chun Lin, Hong Liu, Cang-Hai Wang, Jing Wu, Neng-Wei Zhang, Wei Chen
Aim. To investigate the characteristic of hypertriglyceridemic- (HTG-) induced pancreatitis (HTG pancreatitis). Methods. We reviewed 126 cases of HTG pancreatitis and 168 cases of biliary pancreatitis as control. Results. The HTG group mean age was younger than biliary group. The number of females was a little higher than males in both groups. There were 18 cases that were recurrent in HTG group and 11 in billiary group. The mean hospitalization times were 13.7 ± 2.6 and 11.2 ± 2.3 days in two groups. Six patients received apheresis in HTG group...
2016: Gastroenterology Research and Practice
Sai-Li Xie, Tan-Zhou Chen, Xie-Lin Huang, Chao Chen, Rong Jin, Zhi-Ming Huang, Meng-Tao Zhou
Severe hypertriglyceridemia is a well-known cause of pancreatitis. Usually, there is a moderate increase in plasma triglyceride level during pregnancy. Additionally, certain pre-existing genetic traits may render a pregnant woman susceptible to development of severe hypertriglyceridemia and pancreatitis, especially in the third trimester. To elucidate the underlying mechanism of gestational hypertriglyceridemic pancreatitis, we undertook DNA mutation analysis of the lipoprotein lipase (LPL), apolipoprotein C2 (APOC2), apolipoprotein A5 (APOA5), lipase maturation factor 1 (LMF1), and glycosylphosphatidylinositol-anchored high-density lipoprotein-binding protein 1 (GPIHBP1) genes in five unrelated pregnant Chinese women with severe hypertriglyceridemia and pancreatitis...
2015: PloS One
Jinjiao Liu, Pengfei Xu, Ling Zhang, Abudurexiti Kayoumu, Yunan Wang, Mengyu Wang, Mingming Gao, Xiaohong Zhang, Yuhui Wang, George Liu
Hypertriglyceridemic pancreatitis (HTGP) is often encountered clinically as a common form of recurrent acute pancreatitis (AP). It is important to evaluate the management of severe hypertriglyceridemia (HTG) or anti-inflammation in the prophylaxis of HTGP in the clinic. FTY720 (2-amino-2[2-(4-octylphenyl) ethyl]-1, 3-propanediol) is a new anti-inflammatory agent with low toxicity and reported to ameliorate lung injury with pancreatitis in rat. We evaluated its protective affection on AP induced by seven hourly intraperitoneal injection of cerulein in apolipoprotein CIII transgenic mice with severe HTG...
September 2015: Shock
Wenhua He, Nonghua Lu
BACKGROUND/AIMS: Hypertriglyceridemia (HTG) is recognized as a main cause of acute pancreatitis. The clinical course of hypertriglyceridemic pancreatitis (HTGP) is usually severe and often associated with complications. Patients with HTGP need therapeutic strategies aimed at rapidly reducing triglyceride (TG) serum levels. Here we review the effects of Emergent triglyceride-lowering therapies as well as their ad vantages and controversies. METHODOLOGY: PubMed and MEDLINE were searched for articles using the keywords hypertriglyceridemia", "hyperlipidemia and "pancreatitis until September 2012...
March 2015: Hepato-gastroenterology
Angela Pirillo, Alberico Luigi Catapano
High levels of plasma triglycerides (TG) are a risk factor for cardiovascular diseases, often associated with anomalies in other lipids or lipoproteins. Hypertriglyceridemia (HTG), particularly at very high levels, significantly increases also the risk of acute pancreatitis. Thus, interventions to lower TG levels are required to reduce the risk of pancreatitis and cardiovascular disease. Several strategies may be adopted for TG reduction, including lifestyle changes and pharmacological interventions. Among the available drugs, the most commonly used for HTG are fibrates, nicotinic acid, and omega-3 polyunsaturated fatty acids (usually a mixture of eicosapentaenoic acid, or EPA, and docosahexaenoic acid, or DHA)...
2015: Drug Design, Development and Therapy
Dania Lizet Quintanilla-Flores, Erick Joel Rendón-Ramírez, Perla Rocío Colunga-Pedraza, Jesús Gallardo-Escamilla, Sergio Antonio Corral-Benavides, José Gerardo González-González, Héctor Eloy Tamez-Pérez
OBJECTIVES: Hypertriglyceridemic pancreatitis (HP) is an uncommon condition accounting for 1% to 4% of cases of acute pancreatitis, mostly associated with poor glycemic control. Diabetic ketoacidosis (DKA) may complicate the clinical course of HP. Our objective was to identify clinical and demographic differences between HP and DKA patients compared with those without DKA. METHODS: Fifty-five patients with HP were included. Diabetic ketoacidosis was diagnosed in 8 patients...
May 2015: Pancreas
Yamin Zheng, Zhen Zhou, Haichao Li, Jia Li, Ang Li, Binrong Ma, Taiping Zhang, Quan Liao, Yingjiang Ye, Zhongtao Zhang, Yinmo Yang, Zhenjun Wang, Zaixing Zhang, Jinshan Yang, Fei Li
OBJECTIVES: The aim of this study was to determine the etiology tendency of acute pancreatitis (AP) in the Beijing region and the relationship with influencing factors. METHODS: This retrospective multicenter study enrolled 8 representative general hospitals from January 1, 2006 to December 31, 2010. The etiology tendency was analyzed, and the relationship was defined with sex, aging, severity, mortality, recrudesce rate, length of stay, and hospitalization cost...
April 2015: Pancreas
Abhishek Seth, Saurabh Rajpal, Taru Saigal, John Bienvenu, Ankur Sheth, Jonathan S Alexander, Moheb Boktor, Kenneth Manas, James D Morris, Paul A Jordan
Diabetic ketoacidosis (DKA)-induced hypertriglyceridemia causing pancreatitis is an interesting phenomenon that has rarely been reported in literature. Plasmapharesis is a well known treatment modality for hypertriglyceridemia-induced pancreatitis. We report a patient with DKA-induced hypertriglyceridemic acute pancreatitis treated successfully with plasmapharesis.
2014: Clinical Medicine Insights. Gastroenterology
Nicoletta Costantini, Antonella Mameli, Francesco Marongiu
Severe hypertriglyceridemia is a common indication for the need of plasma exchange in treatment of hypertriglyceridemic-induced pancreatitis when normal therapies fail to garner a response. Application of plasmapheresis to prevent complication of hypertriglyceridemia is limited because of its cost and availability. We present a case of a 44-year-old man with metabolic syndrome and a medical history of secondary polycythemia in obesity hypoventilation syndrome, whose laboratory tests revealed a triglycerides value of 3965 mg/dL...
January 2016: American Journal of Therapeutics
Pedro Valdivielso, Alba Ramírez-Bueno, Nils Ewald
Severe hypertriglyceridemia (HTG) is a well established and the most common cause of acute pancreatitis (AP) after alcohol and gall stone disease. It is alleged to account for up to 10% of all pancreatitis episodes. Studies suggest that in patients with triglyceride (TG) levels>1000 mg/dL (>11.3 mmol/L), hypertriglyceridemia-induced acute pancreatitis (HTGP-AP) occurs in approximately 15-20% of all subjects referred to Lipid Clinics. Until now, there is no clear evidence which patients with severe HTG will develop pancreatitis and which will not...
October 2014: European Journal of Internal Medicine
A Markota, M Knehtl, A Sinkovic, R Ekart, R Hojs, S Bevc
Hypertriglyceridemia is a well-recognized cause of acute pancreatitis. We present a patient with acute hypertriglyceridemic pancreatitis. At presentation serum triglycerides were severely elevated (104 mmol/l) and were decreasing the next day (11 mmol/l). However, based on increasing levels of serum lipase, worsening respiratory failure and evidently lipemic serum, we decided to perform plasma exchange, and patient's condition improved dramatically. Repeated laboratory test of the serum obtained before the first plasma exchange revealed that the actual value of serum triglycerides was 57 mmol/l...
October 2014: Transfusion and Apheresis Science
Sung-Yu Hsu, Wei-Jei Lee, Keong Chong, Kong-Han Ser, Jun-Jiun Tsou
BACKGROUND: It is well established that severe hypertriglyceridemia can lead to pancreatitis. At present, medical treatment for patients with severe hypertriglyceridemia and repeat pancreatitis attacks is not adequate. The aim of this study was to assess the effectiveness of laparoscopic bariatric surgery in these patients. METHODS: A review of 20 morbidly obese patients with severe hypertriglyceridemia (a triglyceride level of >1000 mg/dL) who received laparoscopic bariatric surgery was performed...
April 2015: Asian Journal of Surgery
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