title: Acute pancreatitis associated with severe hypertriglyceridaemia; A retrospective cohort study.
abstract: OBJECTIVE
  Acute Pancreatitis (AP) secondary to hypertriglyceridaemia (HTG) is a rare association of which little is known in the literature. This study investigates patient characteristics and outcomes (reoccurrence and mortality) in those presenting with AP secondary to HTG in one of the largest reported British cohorts.
  
  
  METHODS
  A retrospective observational case note review of all patients treated at our institution between 2004 and 2012. Data are expressed as mean and standard deviation if parametric and as median and range if non-parametric. Full fasting lipid profiles and patient demographics were recorded to elucidate further the cause of the severe hypertriglyceridaemia (>10 mmol/L fasting).
  
  
  RESULTS
  There were 784 patients admitted with AP admitted to our institution within the study period. APHTG was present in 18 patients (2.3%). Peak serum triglyceride concentration was 43.9 mmol/L, SD 18.9 mmol/L. Serum amylase activity was 'falsely' low (with raised urine amylase) in about 10% of the patients with acute pancreatitis and hypertriglyceridaemia. 67% of our patients had type 2 diabetes mellitus or impaired glucose tolerance, 28% had a fatty liver and 50% displayed alcohol excess all these conditions are known to be associated with HTG There was a 94.5% reduction in serum triglyceride between presentation and last follow-up visit. There were also no deaths or recurrent episodes of AP during the study period.
  
  
  CONCLUSIONS
  APHTG was present in 2.3% of patients presenting with AP. The reoccurrence and mortality rates were zero in this cohort. This may in part be due to aggressive serum triglyceride lowering by a multi-disciplinary team. Early clinical recognition is vital to provide targeted treatment and to try and reduce further episodes of AP.
authors.affiliation: Dept of Gastroenterology, University Hospital Lewisham, Lewisham, London, SE13 6LH, United Kingdom.
authors.forename: Annika
authors.initials: A
authors.lastname: Charlesworth
authors.affiliation: Dept of Surgery, University Hospital Lewisham, Lewisham, London, SE13 6LH, United Kingdom.
authors.forename: Adrian
authors.initials: A
authors.lastname: Steger
authors.affiliation: Department of Clinical Biochemistry, University Hospital Lewisham, Lewisham, London, SE13 6LH, United Kingdom. Electronic address: m.crook@nhs.net.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Crook
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000201:enzymology / Q000209:etiology* / Q000401:mortality; D012008:Recurrence; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D000681:Amylases
keywords: Acute pancreatitis; Amylase; Fibrates; Hypertriglyceridaemia; Lipaemia; Statins