title: Therapeutic plasma exchange in patients with severe hypertriglyceridemia: a multicenter study.
abstract: Extremely high plasma triglyceride (TG) concentration is a recognized risk factor for acute pancreatitis (AP). In order to evaluate the therapeutic efficacy of plasma-exchange plasmapheresis in treating patients with severe hypertriglyceridemia (sHTG), 17 patients who had not responded to conventional medical therapy (fat-free diet plus pharmaceutical interventions) were referred for therapeutic plasma exchange (TPE) in a multicenter frame case series study. Two hundred seventeen TPE sessions were performed, and therapy is ongoing for five (30%) of the patients. After treatment, the mean plasma TG and total cholesterol concentrations were significantly reduced from 1929 and 510 mg/dL, to 762 and 227 mg/dL, respectively (P < or = 0.001 in both cases). In most cases, the interval between treatments was related to the clinical presentation and individual circumstances. The removal of TG-rich lipoproteins prevented relapses of AP. In this case series, TPE is confirmed as a safe and reliable method for treating patients with refractory sHTG when a severe complication, such as AP, is clinically demonstrated or can be actively prevented. Therefore, in cases where standard medical approaches fail to promote the clearance of TGs from plasma and a high risk of first or second hypertriglyceridemic pancreatitis persists, TPE provides a therapeutic option for preventing life-threatening sHTG.
authors.affiliation: University of Rome La Sapienza, Umberto I Hospital, Department of Clinical and Medical Therapy, Plasmapheresis Unit, Rome, Italy. cstefanutti@alice.it
authors.forename: Claudia
authors.initials: C
authors.lastname: Stefanutti
authors.forename: Serafina
authors.initials: S
authors.lastname: Di Giacomo
authors.forename: Antonio
authors.initials: A
authors.lastname: Vivenzio
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Labbadia
authors.forename: Fabio
authors.initials: F
authors.lastname: Mazza
authors.forename: Giovanna
authors.initials: G
authors.lastname: D'Alessandri
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Russi
authors.forename: Giustina
authors.initials: G
authors.lastname: De Silvestro
authors.forename: Piero
authors.initials: P
authors.lastname: Marson
mesh_terms: D000208:Acute Disease; D000328:Adult; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D012008:Recurrence; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D002784:Cholesterol