Long-term follow-up of patients with acute hypertriglyceridemia-induced pancreatitis.
BACKGROUND
An acute and potentially life-threatening complication of hypertriglyceridemia (HTG) is acute pancreatitis (AP). Hypertriglyceridemia, usually severe, may be primary in origin or secondary to alcohol abuse, diabetes mellitus, pregnancy, and use of drugs.


METHODS
The efficacy of treatment to prevent relapses in 17 patients with AP attributed to HTG was investigated in the current prospective study. The mean follow-up period of patients was 42 months. Hypertriglyceridemia-induced AP comprised 6.9% of all patients with AP (n = 246) hospitalized in our clinic during the study (6 years).


RESULTS
Causative conditions of HTG-induced AP were familial HTG in eight patients, HTG caused by uncontrolled diabetes mellitus in five, HTG aggravated by drugs in two (one by tamoxifen and one by fluvastatin), familial hyperchylomicronemia (HCM) in one, and lipemia of pregnancy in one. During the acute phase of pancreatitis, patients underwent standard treatment. Thereafter, HTG was efficiently controlled with high dosages of fibrates or a fibrate plus acipimox, except for the patient with HCM, who was on a specific diet (the only source of fat was a special oil consisting of medium chain triglyceride) and taking a high dosage of acipimox. One of the patients died during the acute phase of pancreatitis with acute respiratory distress syndrome. During follow-up, maintenance treatment was successful and only one patient relapsed, because he discontinued diet and drug treatment.


CONCLUSIONS
Appropriate diet and drug treatment, including dose titration, of severe HTG is very effective in preventing relapses of HTG-induced AP.
Athyros
Vassilios G
VG
Lipid Out-Patient, 2nd Propedeutic Department of Internal Medicine, Aristotelian University, Hippocration Hospital, Thessaloniki, Greece. athyros@med.auth.gr
Giouleme
Olga I
OI
Nikolaidis
Nikolaos L
NL
Vasiliadis
Themistoklis V
TV
Bouloukos
Vassilios I
VI
Kontopoulos
Athanasios G
AG
Eugenidis
Nikolaos P
NP
D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000145:classification / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome