Extracorporeal lipid elimination for treatment of gestational hyperlipidemic pancreatitis.
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.
Swoboda
K
K
Department of Nephrology, Medical Clinic III, Vienna, Austria.
Derfler
K
K
Koppensteiner
R
R
Langer
M
M
Pamberger
P
P
Brehm
R
R
Ehringer
H
H
Druml
W
W
Widhalm
K
K
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
D008074:Lipoproteins