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Hypertriglyceridemic Pancreatitis

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https://www.readbyqxmd.com/read/28670087/plasmapheresis-for-recurrent-acute-pancreatitis-from-hypertriglyceridemia
#1
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/28548292/hypertriglyceridemic-acute-pancreatitis-in-emergency-department-typical-clinical-features-and-genetic-variants
#2
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 patients with hypertriglyceridemic acute pancreatitis (HTGAP), and the molecular foundation contributing to hypertriglyceridemia in such patients. METHODS: Clinical data from 329 patients with acute pancreatitis (AP) were analyzed. The patients were divided into the HTGAP group, with fasting serum triglyceride (TG) levels ≥500 mg/dL (5.65 mmol/L), and the non-HTGAP (NHTGAP) group. Targeted next-generation sequencing was applied to 11 HTGAP patients to identify the genetic mutations associated with hypertriglyceridemia, including apolipoprotein A-V (APOA5), APOC2, APOC3 and APOE, BLK, LPL, GPIHBP1 and LMF1...
June 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28414683/recurrent-hypertriglyceridemic-pancreatitis-htgp-and-the-use-of-insulin-drip-as-treatment
#3
T Tran, N Lee
INTRODUCTION: Chronic pancreatitis by definition is a recurrent episode of acute pancreatitis and is commonly associated with alcoholism in the US. Another cause of chronic pancreatitis is hypertriglyceridemia (HTGP);, occurring in 1-5 percent of cases. The incidence of HTGP is higher in patients with diabetes and HIV, usually requiring triglyceride levels > 1000 mg/dL. CASE: A 33 year old man with uncontrolled type 1 diabetes and recurrent pancreatitis, first diagnosed 5 years prior, presented as a transfer from an outside hospital for a recurrent episode of HTGP...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28380195/duodenal-jejunal-bypass-normalizes-pancreatic-islet-proliferation-rate-and-function-but-not-hepatic-steatosis-in-hypothalamic-obese-rats
#4
K R Cantelli, G M Soares, R A Ribeiro, S L Balbo, C Lubaczeuski, A C Boschero, A C F Araújo, M L Bonfleur
Modifications in life-style and/or pharmacotherapies contribute to weight loss and ameliorate the metabolic profile of diet-induced obese humans and rodents. Since these strategies fail to treat hypothalamic obesity, we have assessed the possible mechanisms by which duodenal-jejunal bypass (DJB) surgery regulates hepatic lipid metabolism and the morphophysiology of pancreatic islets, in hypothalamic obese (HyO) rats. During the first 5 days of life, male Wistar rats received subcutaneous injections of monosodium glutamate (4 g/kg body weight, HyO group), or saline (CTL)...
March 30, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28079184/development-of-a-novel-model-of-hypertriglyceridemic-acute-pancreatitis-in-mice
#5
Yiyuan Pan, Yong Li, Lin Gao, Zhihui Tong, Bo Ye, Shufeng Liu, Baiqiang Li, Yizhe Chen, Qi Yang, Lei Meng, Yuhui Wang, George Liu, Guotao Lu, Weiqin Li, Jieshou Li
The morbidity rate of hypertriglyceridemic acute pancreatitis (HTG-AP) increased rapidly over the last decade. However an appropriate animal model was lacking to recapitulate this complicated human disease. We established a novel mice model of HTG-AP by poloxamer 407 (P-407) combined with caerulein (Cae). In our study, serum triglyceride levels of P-407 induced mice were elevated in a dose-dependent manner, and the pancreatic and pulmonary injuries were much severer in HTG mice than normal mice when injected with conventional dose Cae (50 ug/kg), what's more, the severity of AP was positively correlative with duration and extent of HTG...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28024293/modulation-of-the-lipid-profile-and-insulin-levels-of-streptozotocin-induced-diabetic-rats-by-ethanol-extract-of-cnidoscolus-aconitifolius-leaves-and-some-fractions-effect-on-the-oral-glucose-tolerance-of-normoglycemic-rats
#6
N K Achi, O C Ohaeri, I I Ijeh, C Eleazu
BACKGROUND: No study to date has investigated the effect of different polar solvent extracts from Cnidoscolus aconitifolius leaves on glycemic control as used in folk medicine. Hence this study which investigated the effect of ethanol extract and fractions of C. aconitifolius leaves on body weights, relative organ weights, serum levels of glucose, lipid profiles and insulin in streptozotocin induced diabetic rats and on oral glucose tolerance of normoglycemic rats. METHODS: The ethanol extract was partitioned using methanol, hexane and chloroform to obtain different fractions...
February 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28005494/glomerular-lesions-in-proteinuric-miniature-schnauzer-dogs
#7
E Furrow, G E Lees, C A Brown, R E Cianciolo
Miniature Schnauzer dogs are predisposed to idiopathic hypertriglyerceridemia, which increases risk for diseases such as pancreatitis and gallbladder mucocele. Recently, elevated triglyceride concentrations have been associated with proteinuria in this breed, although it is difficult to determine which abnormality is primary. Retrospective review of renal tissue from 27 proteinuric Miniature Schnauzers revealed that 20 dogs had ultrastructural evidence of osmophilic globules consistent with lipid in glomerular tufts...
May 2017: Veterinary Pathology
https://www.readbyqxmd.com/read/27789124/use-of-the-apache-ii-score-to-assess-impact-of-therapeutic-plasma-exchange-for-critically-ill-patients-with-hypertriglyceride-induced-pancreatitis
#8
Shazia Nakhoda, Ann B Zimrin, Maria R Baer, Jennie Y Law
OBJECTIVES: Hypertriglyceridemic (HTG) pancreatitis carries significant morbidity and mortality and often requires intensive care unit (ICU) admission. Therapeutic plasma exchange (TPE) rapidly lowers serum triglyceride (TG) levels. However, evidence supporting TPE for HTG pancreatitis is lacking. METHODS: Ten patients admitted to the ICU for HTG pancreatitis underwent TPE at our institution from 2005-2015. We retrospectively calculated the Acute Physiology and Chronic Health Examination II (APACHE II) score at the time of initial TPE and again after the final TPE session to assess the impact of triglyceride apheresis on morbidity and mortality associated with HTG pancreatitis...
April 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/27727299/relationship-between-plasma-triglyceride-level-and-severity-of-hypertriglyceridemic-pancreatitis
#9
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
https://www.readbyqxmd.com/read/27596553/-comparison-of-severity-and-clinical-outcomes-between-hypertriglyceridemic-pancreatitis-and-acute-pancreatitis-due-to-other-causes
#10
COMPARATIVE STUDY
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]
https://www.readbyqxmd.com/read/27578123/clinical-and-genetic-features-of-3-patients-with-familial-chylomicronemia-due-to-mutations-in-gpihbp1-gene
#11
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
https://www.readbyqxmd.com/read/27574886/emergent-triglyceride-lowering-therapy-with-early-high-volume-hemofiltration-against-low-molecular-weight-heparin-combined-with-insulin-in-hypertriglyceridemic-pancreatitis-a-prospective-randomized-controlled-trial
#12
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
https://www.readbyqxmd.com/read/27512482/presentation-and-management-of-acute-hypertriglyceridemic-pancreatitis-in-pregnancy-a-case-report
#13
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
https://www.readbyqxmd.com/read/27406459/hypertriglyceridemic-pancreatitis-associated-with-confounding-laboratory-abnormalities
#14
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
https://www.readbyqxmd.com/read/27042605/differences-in-severity-and-outcomes-between-hypertriglyceridemia-and-alcohol-induced-pancreatitis
#15
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
https://www.readbyqxmd.com/read/26965545/fasting-or-nonfasting-lipid-measurements-it-depends-on-the-question
#16
REVIEW
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
https://www.readbyqxmd.com/read/26880892/a-retrospective-research-of-the-characteristic-of-hypertriglyceridemic-pancreatitis-in-beijing-china
#17
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
https://www.readbyqxmd.com/read/26079787/genetic-variants-associated-with-gestational-hypertriglyceridemia-and-pancreatitis
#18
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
https://www.readbyqxmd.com/read/25944794/fty720-attenuates-acute-pancreatitis-in-hypertriglyceridemic-apolipoprotein-ciii-transgenic-mice
#19
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
https://www.readbyqxmd.com/read/25916076/emergent-triglyceride-lowering-therapy-for-hypertriglyceridemic-pancreatitis
#20
REVIEW
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
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