title: Diagnostic evaluation of acute pancreatitis in two patients with hypertriglyceridemia.
abstract: We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type V hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels. The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis. Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist, exhibiting a relief of abdominal symptoms. As in the present cases with acute abdomen following the ingestion of fatty food, the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen, when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Fukuoka Dental College Hospital, 2-15-1, Tamura, Sawara-ku, Fukuoka 814-0193, Japan. okuray@college.fdcnet.ac.jp
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Okura
authors.forename: Kozo
authors.initials: K
authors.lastname: Hayashi
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Shingu
authors.forename: Goro
authors.initials: G
authors.lastname: Kajiyama
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakashima
authors.forename: Keijiro
authors.initials: K
authors.lastname: Saku
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000175:diagnosis*; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides