[Excessive hyperchylomicronemia--a rare cause of acute retrosternal and epigastric pain in pregnancy].
METHODS
A 24-year-old woman in her 13th gestational was admitted to our department with acute retrosternal and epigastric pain. She had been transferred from the gynecologic department where she was treated for vaginal bleeding because of abortus imminens. A cardiac cause was excluded by ECG and echo. Clinical chemistry and abdominal ultrasound confirmed the diagnosis of acute pancreatitis. The woman was known in our outpatient department for hyperchylomicronemia and had already had an earlier episode of acute pancreatitis under oral contraception years ago. At current admission, triglycerides were 11,500 mg/dl. To reduce plasma triglycerides, selective lipid apheresis was performed. Apheresis was well tolerated, and the patient became free of pain within the first 30 min of treatment. Triglycerides decreased to 6,600 mg/dl at this session. Keeping to a low-fat diet (< 30 g fat per day), the patient remained healthy and completed pregnancy with the delivery of a healthy girl in her 39th week of pregnancy.


CONCLUSIONS
Selective lipid apheresis is a safe and effective option in the treatment of hyperlipidemic pancreatitis, even in pregnant patients.
Sattler
Alexander M
AM
Klinik für Innere Medizin - Kardiologie, Klinikum der Philipps-Universität, Marburg. alexander.sattler@mailer.uni-marburg.de
Bock
Karin
K
Schmidt
Stephan
S
Maisch
Bernhard
B
Schaefer
Juergen R
JR
D015746:Abdominal Pain / Q000097:blood / Q000209:etiology*; D000208:Acute Disease; D000328:Adult; D002637:Chest Pain / Q000097:blood / Q000209:etiology*; D003131:Combined Modality Therapy; D018752:Diet, Fat-Restricted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008072:Hyperlipoproteinemia Type I / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D006953:Hyperlipoproteinemia Type IV / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D007231:Infant, Newborn; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D011261:Pregnancy Trimester, First; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides