[Acute pancreatitis caused by hypertriglyceridemia].
Hypertriglyceridemia is reported to cause 1-7% of the cases of acute pancreatitis.


OBJECTIVE
The aim of the present study was to assess the clinical features and management of pancreatitis with hypertriglyceridemia in our tertiary center.


METHODS
Between 1 January 2007 and 31 December 2009, patients with a diagnosis of hypertriglyceridemia-induced acute pancreatitis were reviewed. Patients with pancreatitis and serum triglyceride levels greater than 11.3 mmol/l (≈1000 mg/dl) were included. Acute pancreatitis with other etiologies was excluded.


RESULTS
26 patients (2 women, 24 men; median age at presentation 42 years; range: 22-70) were diagnosed with hypertriglyceridemia‑induced acute pancreatitis; 3 patients had altogether 7 relapses. The total number of cases was 33, which accounted for 4.71% of the total number of acute pancreatitis cases in the examined period. There was a failure in diet in 30.3% and a history of regular alcohol abuse in 57.6% of the cases. A history of diabetes mellitus was present in 38.1%, and gallstones in 9.1% of the cases. Lactescent serum was described on admission in 27.3%. Mean triglyceride level was 47.24 mmol/l (≈4181 mg/dl; 12.4-103.8 mmol/l). Amylase level was elevated to three times the normal in 54.5%, and that of lipase to three times the normal in 58.8%. Necrotizing acute pancreatitis was diagnosed in 7 patients (26.9%), and pseudocyst in 8 patients (30.7%). Administration of insulin, heparin, plasmapheresis and fibrates lowered the triglyceride to 3.71 mmol/l (≈328 mg/dl).


CONCLUSIONS
The clinical course of acute pancreatitis with hypertriglyceridemia does not differ from acute pancreatitis of other causes. Interestingly, levels of serum pancreatic enzymes may be normal or only minimally elevated. Insulin, heparin, plasmapheresis and fibrates effectively reduce lipid levels and relieve symptoms. A low triglyceride level is necessary to prevent relapses.
Baranyai
Tamás
T
Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Pf. 469 6701.
Terzin
Viktória
V
Vajda
Agota
A
Wittmann
Tibor
T
Czakó
László
L
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications; D000681:Amylases / Q000097:blood; D000925:Anticoagulants / Q000008:administration & dosage; D048909:Diabetes Complications / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D005247:Feeding Behavior; D005260:Female; D058607:Fibric Acids / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000150:complications*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000209:etiology; D010956:Plasmapheresis; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood*
D000925:Anticoagulants; D058607:Fibric Acids; D007004:Hypoglycemic Agents; D007328:Insulin; D014280:Triglycerides; D006493:Heparin; D008049:Lipase; D000681:Amylases
Hypertriglyceridaemia okozta akut pancreatitis sajátosságai beteganyagunkban.