title: Hypertriglyceridemia-Induced Pancreatitis: A Decade of Experience in a Community-Based Teaching Hospital.
abstract: BACKGROUND
  Hypertriglyceridemia is the third most common cause of acute pancreatitis. The current evidence on the management of hypertriglyceridemia-induced pancreatitis (HTGP) is mainly derived from case series. It has been suggested that insulin, and plasmapheresis have a role in the management of acute HTGP. We present a retrospective review of patients seen at a community-teaching hospital between 2005 and 2015.
  
  
  RESULTS
  Out of the 549 admissions for acute pancreatitis, fourteen patients met our inclusion criteria. The mean age of presentation was 39± 8 years and there was a predominance of men (57%). More than two-thirds of the patients were admitted to the intensive care unit. The majority of the patients were treated with insulin drip (n=8), and the rest by subcutaneous insulin (n=3) and insulin drip + plasmapheresis (n=3). In the insulin drip group we noted a gradual decrease of the admission serum triglycerides by 50.6 ±16.0 % at 24 hours, 65.9±16.9% at 48 hours, and then 85.2± 7.1% at discharge. Serum triglycerides decreased by 79.8% and 92.6%, at discharge in the subcutaneous insulin and insulin + plasmapheresis cohorts, respectively. The insulin + plasmapheresis cohort stayed in the hospital longer (20.7±3.1 days) compared to the insulin drip (10.3±5.4 days) and subcutaneous insulin (5.7 ± 1.2 days) cohorts.
  
  
  CONCLUSIONS
  Our study strengthens the evidence for using insulin (infusion or subcutaneous) with or without plasmapheresis in the treatment of hypertriglycerimia-induced pancreatitis.
authors.affiliation: Cardiovascular Fellow at St Elizabeth Medical Center, Tuft University School of Medicine. He is an alumnus of the internal medicine residency program at Memorial Hospital of Rhode Island/Alpert Medical School of Brown University.
authors.forename: Maxwell Eyram
authors.initials: ME
authors.lastname: Afari
authors.affiliation: Hematology-Oncology Fellow at Medical University of South Carolina. He is an alumnus of the internal medicine residency at Memorial Hospital of Rhode Island/Alpert Medical School of Brown University.
authors.forename: Hammad
authors.initials: H
authors.lastname: Shafqat
authors.affiliation: PGY3 Internal Medicine resident at Memorial Hospital of Rhode Island, Alpert Medical School of Brown University.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Shafi
authors.affiliation: PGY3 Internal Medicine resident at Memorial Hospital of Rhode Island, Alpert Medical School of Brown University.
authors.forename: Fady Y
authors.initials: FY
authors.lastname: Marmoush
authors.affiliation: Statistical Programmer at Center for Primary Care and Prevention, Memorial Hospital of Rhode Island.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Roberts
authors.affiliation: Assistant Professor of Medicine at Alpert Medical School of Brown University and Attending Physician of Pulmonary, Critical Care and Sleep Medicine at Memorial Hospital of Rhode Island.
authors.forename: Taro
authors.initials: T
authors.lastname: Minami
mesh_terms: D000328:Adult; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000188:drug therapy / Q000209:etiology; D010956:Plasmapheresis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D014280:Triglycerides
keywords: Acute pancreatitis; Hypertriglyceridemia; Plasmapheresis; insulin therapy