Plasmapheresis in the treatment of an acute pancreatitis due to protease inhibitor-induced hypertriglyceridemia.
The use of protease inhibitors such as ritonavir to treat HIV-infected individuals has been associated with lipodystrophy, combined hyperlipidemias, and hypertriglyceridemia-induced pancreatitis. We report here on the treatment by plasmapheresis of a HIV-patient who presented with a rapid onset of severe ritonavir-induced hypertriglyceridemia complicated with an acute pancreatitis. A 35-year-old HIV-1 positive male following 3 weeks of ritonavir treatment presented with nausea, abdominal pain, a distended abdomen, and the following laboratory values: amylase (238 U/L), lipase (864 U/L), total cholesterol (27.1 mmol/L), and triglycerides (62.9 mmol/L). Following two plasmaphereses, the levels of total cholesterol, triglycerides, lipase, and amylase declined drastically and the patient was discharged home after 4 days with lipid and pancreatic enzyme levels within the reference range. To our knowledge, this is the first case of pancreatitis due to a PI-induced hyperlipidemia in a HIV-patient treated with plasmapheresis in an acute setting.
Routy
J P
JP
Division of Hematology, McGill University Health Centre, Montreal, Quebec, USA.
Smith
G H
GH
Blank
D W
DW
Gilfix
B M
BM
D000208:Acute Disease; D000328:Adult; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D015228:Hypertriglyceridemia / Q000139:chemically induced*; D008297:Male; D010195:Pancreatitis / Q000209:etiology* / Q000628:therapy*; D010956:Plasmapheresis; D011480:Protease Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D019438:Ritonavir / Q000008:administration & dosage / Q000009:adverse effects
D011480:Protease Inhibitors; D019438:Ritonavir