title: Extracorporeal lipid elimination for treatment of gestational hyperlipidemic pancreatitis.
abstract: Gestational hyperlipidemia complicated by pancreatitis during the 24th week of gestation has been successfully managed by long-term extracorporeal elimination of triglyceride-rich lipoproteins. Three modes of treatment (plasma exchange, immunospecific apheresis, and a combination of both treatments) were compared for efficacy as therapy for metabolic derangements, altered blood rheology, and the loss of immunoglobulins. Treatments were performed by means of a peripheral venovenous approach. A combination plasma exchange/apheresis technique was highly effective; the loss of immunoglobulins remained acceptable. Clinical symptoms of pancreatitis subsided within 24 hours of the first treatment. A relapse during the 32nd week of gestation necessitated treatments more frequently than once a week. At the 36th week of gestation, after confirming lung maturity as indicated by a lecithin-sphingomyelin ratio of > 2.0, a cesarean section was performed. A healthy boy was delivered (2470 g; Apgar score, 9/10). This is the first report to show that long-term extracorporeal elimination of lipoproteins is a highly effective treatment of hyperlipidemic gestational pancreatitis.
authors: Department of Nephrology, Medical Clinic III, Vienna, Austria.
authors: K
authors: K
authors: Swoboda
authors: K
authors: K
authors: Derfler
authors: R
authors: R
authors: Koppensteiner
authors: M
authors: M
authors: Langer
authors: P
authors: P
authors: Pamberger
authors: R
authors: R
authors: Brehm
authors: H
authors: H
authors: Ehringer
authors: W
authors: W
authors: Druml
authors: K
authors: K
authors: Widhalm
mesh_terms: D000328:Adult; D001781:Blood Component Removal; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications*; D008074:Lipoproteins / Q000097:blood; D010195:Pancreatitis / Q000097:blood / Q000628:therapy*; D010951:Plasma Exchange; D011247:Pregnancy; D011248:Pregnancy Complications
chemical_list: D008074:Lipoproteins