title: Severe hypertriglyceridemia-induced pancreatitis during pregnancy.
abstract: Chylomicronemia syndrome is a rare disorder characterized by the presence of chylomicrons in the fasting state. An acute and potentially life-threatening complication of chyiomicronemia syndrome is severe acute pancreatitis. We report a case of a 24-year-old primigravida with severe hypertriglyceridemia-induced pancreatitis. We reviewed the clinical course and treatment of hypertriglyceridemia-induced pancreatitis. She was admitted in the 37th week of gestation with severe abdominal pain, which was radiating to the back, and having uterine contractions. Cesarean delivery was performed under spinal anesthesia, and a healthy male infant was born. Intraoperative findings included milky peritoneal fluid collection. Elevated pancreatic enzymes with significant hypertriglyceridemia (10,092 mg/dL) suggesting acute pancreatitis were also found on chemical analysis. The diagnosis of acute pancreatitis was confirmed by computed tomography scan. Treatment with continuous intravenous insulin--glucose, cessation of oral intake, and nasogastric decompression--dramatically decreased the triglyceride levels to 608 mg/dL within five days. She was discharged as symptom free with strict dietary intervention after 10 days. Intravenous insulin is a low-cost and effective alternative treatment in hypertriglyceridemia-induced pancreatitis during pregnancy. To our knowledge, such a high triglyceride level has not previously been reported in pregnancy.
authors.affiliation: Faculty of Medicine, Department of Endocrinology and Metabolism, Baskent University, Ankara, Turkey. alptekingursoy@hotmail.com
authors.forename: Alptekin
authors.initials: A
authors.lastname: Gürsoy
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kulaksizoglu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sahin
authors.forename: Derun Taner
authors.initials: DT
authors.lastname: Ertugrul
authors.forename: Feyza
authors.initials: F
authors.lastname: Ozer
authors.forename: Neslihan Bascil
authors.initials: NB
authors.lastname: Tutuncu
authors.forename: Nilgun Guvener
authors.initials: NG
authors.lastname: Demirag
mesh_terms: D000208:Acute Disease; D000328:Adult; D002585:Cesarean Section; D002784:Cholesterol / Q000097:blood; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications* / Q000178:diet therapy; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D010195:Pancreatitis / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery; D011263:Pregnancy Trimester, Third; D014280:Triglycerides / Q000097:blood
chemical_list: D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol; D005947:Glucose