title: Systematic review of hypertriglyceridemia-induced acute pancreatitis: A more virulent etiology?
abstract: OBJECTIVE
  We sought to define the severity and natural history of hypertriglyceridemia induced acute pancreatitis (HTG-AP), specifically whether HTG-AP causes more severe AP than that caused by other etiologies.
  
  
  METHODS
  Systematic review of the English literature.
  
  
  RESULTS
  Thirty-four studies (15 countries; 1972-2015) included 1340 HTG-AP patients (weighted mean prevalence of 9%). The median admission triglyceride concentration was 2622 mg/dl (range 1160-9769). Patients with HTG have a 14% weighted mean prevalence of AP. Plasmapheresis decreased circulating triglycerides, but did not conclusively affect AP mortality. Only 7 reports (n = 392 patients) compared severity of HTG-AP to that of AP from other etiologies. Of these, 2 studies found no difference in severity, while 5 suggested that HTG-AP patients may have increased severity compared to AP of other etiology.
  
  
  CONCLUSIONS
  1) hypertriglyceridemia is a relatively uncommon (9%) cause of acute pancreatitis; however, patients with hypertriglyceridemia have a high (14%) incidence of acute pancreatitis; 2) plasmapheresis may offer specific therapy unique to this patient population; and 3) data specifically comparing the severity of HTG-AP with AP caused by other etiologies are heterogeneous and scarce.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Rosalie A
authors.initials: RA
authors.lastname: Carr
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Rejowski
authors.affiliation: Gastroenterology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Cote
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Henry A
authors.initials: HA
authors.lastname: Pitt
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address: nzyromsk@iupui.edu.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Zyromski
mesh_terms: D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides
keywords: Acute pancreatitis; Etiology; Hypertriglyceridemia; Necrotizing pancreatitis; Plasmapheresis; Systematic review