Plasmapheresis in the management of acute severe hyperlipidemic pancreatitis: report of 5 cases.
OBJECTIVE
Hyperlipidemic pancreatitis is an acute and potentially life-threatening complication of hypertriglyceridemia that can be provoked when triglyceride levels (TGL) exceed 11.3 mmol/l (1,000 mg/dl). Except for standard symptomatic treatment, plasmapheresis has been performed to rapidly reduce TGL and chylomicron levels in the blood. In 5 patients with hyperlipidemic pancreatitis, treatment with plasmapheresis was evaluated.


METHODS
Five male patients who suffered from acute pancreatitis with severe primary hyperlipidemia were studied. In addition to the standard treatment, they were treated with plasmapheresis.


RESULTS
Plasma exchange lowered the lipid level and TGLs in all cases. It also improved abdominal pain, the clinical state of the patients, and signs and symptoms of the disease. Complications of treatment were not encountered, none of the patients died and only 1 patient underwent surgery. Follow-up of the patients lasted 4-28 months, and recurrence of pancreatitis was not noted.


CONCLUSIONS
Our study showed that plasmapheresis was successfully applied in patients with hyperlipidemic pancreatitis, especially to improve the acute phase of the disease.
Kyriakidis
A V
AV
Department of Surgery, Renal Dialysis Unit, Sismanogleion Hospital, Athens, Greece. alkidi@hotmail.com
Karydakis
P
P
Neofytou
N
N
Pyrgioti
M
M
Vasilakakis
D
D
Digenis
P
P
Antsaklis
G
G
D000208:Acute Disease; D000328:Adult; D006801:Humans; D006949:Hyperlipidemias / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000628:therapy*; D010956:Plasmapheresis; D012720:Severity of Illness Index; D016896:Treatment Outcome