title: Hypertriglyceridemia Induced Pancreatitis in a Non-Diabetic Pregnant Patient Requiring the Use of Total Parenteral Nutrition.
abstract: Hypertriglyceridemia induced pancreatitis in pregnancy is established and has been widely reported. However there are very scanty reports of cases involving the use of total parenteral nutrition. We report the case of a 37-year-old gravida 3, para 2 woman at 34 weeks of gestation who presented with one day of severe epigastric pain radiating to the back, nausea and bilious vomiting caused by pancreatitis induced by hypertriglyceridemia. Her initial serum triglyceride, amylase and lipase concentration were 6,552 mg/dl, 314 U/L and 537 U/L respectively. She initially received intravenous fluids and insulin with reduction of serum triglyceride levels to 583 mg/dl on the fifth day of admission. However attempts to refeed the patient with solid food resulted in induction of hypertriglyceridemia and relapse of pancreatitis. Lipid free total parenteral nutrition was commenced in the third week of admission and lead to a better control of triglyciderides and resolution of pancreatitis until delivery of a full term healthy neonate.
authors.affiliation: Division of Gastroenterology, Bronx Lebanon Hospital Center, Bronx, New York 10457, USA.
authors.forename: Ariyo
authors.initials: A
authors.lastname: Ihimoyan
authors.affiliation: Division of Gastroenterology, Bronx Lebanon Hospital Center, Bronx, New York 10457, USA.
authors.forename: Haritha
authors.initials: H
authors.lastname: Chelimilla
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Bronx, New York 10457, USA.
authors.forename: Nirisha
authors.initials: N
authors.lastname: Kalakada
authors.affiliation: Division of Gastroenterology, Bronx Lebanon Hospital Center, Bronx, New York 10457, USA.
authors.forename: Anil
authors.initials: A
authors.lastname: Dev
authors.affiliation: Division of Gastroenterology, Bronx Lebanon Hospital Center, Bronx, New York 10457, USA.
authors.forename: Kavitha
authors.initials: K
authors.lastname: Kumbum
keywords: Gestastional hypertriglyceridemic pancreatitis; Total parenteral nutrition