title: Management of acute severe hyperlipidemic pancreatitis.
abstract: OBJECTIVE
  Hypertriglyceridemia is rare and can provoke acute severe hyperlipidemic pancreatitis when triglyceride levels exceed 11.3 mmol/l. In 10 patients we evaluated the therapeutic guidelines for severe hyperlipidemic pancreatitis.
  
  
  METHODS
  Ten patients (8 men and 2 women) were admitted to the intensive care unit with a diagnosis of acute severe hyperlipidemic pancreatitis. They underwent standard treatment. Heparin, insulin and antihyperlipidemic drugs were used to lower the triglyceride levels. The patients underwent plasmapheresis within 48 h of admission, and fat-free parenteral nutrition was used. Two of the patients underwent surgery because of infection of necrotic segments.
  
  
  RESULTS
  Standard treatment was essential for all the patients but plasmapheresis was the procedure that lowered the triglyceride and lipid levels in all cases. It improved abdominal pain, clinical state, and signs and symptoms of the disease. Two patients underwent surgery due to infection of the necrotic segments and one of them died. Follow-up lasted 4-54 months with no recurrences of pancreatitis.
  
  
  CONCLUSIONS
  Our study shows that standard treatment is essential, but plasmapheresis successfully lowered lipid levels with no complications and relieved the patients from the symptoms in the acute phase of the disease. Hyperlipidemic pancreatitis should initially be treated conservatively. Plasmapheresis is a method that has lately been used successfully for hyperlipidemic pancreatitis. It seems that all therapeutic measures should be applied as early as possible, within the first 48 h.
authors.affiliation: Intensive Care Unit, General Hospital Sismanogleion, Athens, Greece. alkidi@hotmail.com
authors.forename: A V
authors.initials: AV
authors.lastname: Kyriakidis
authors.forename: B
authors.initials: B
authors.lastname: Raitsiou
authors.forename: A
authors.initials: A
authors.lastname: Sakagianni
authors.forename: V
authors.initials: V
authors.lastname: Harisopoulou
authors.forename: M
authors.initials: M
authors.lastname: Pyrgioti
authors.forename: A
authors.initials: A
authors.lastname: Panagopoulou
authors.forename: N
authors.initials: N
authors.lastname: Vasilakis
authors.forename: S
authors.initials: S
authors.lastname: Lambropoulos
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood / Q000139:chemically induced / Q000628:therapy*; D010288:Parenteral Nutrition / Q000379:methods*; D010956:Plasmapheresis / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D014280:Triglycerides