Our Experience on Patients with Hypertriglyceridemia-Induced Acute Pancreatitis and Plasmapheresis

Yıl 2017, Cilt: 16 Sayı: 3, 115 - 117, 20.11.2017

Muhammet Yener Akpınar , Erkin Öztaş , Zeki Mesut Yalın Kılıç Mustafa Kaplan , Volkan Gökbulut Ertuğrul Kayaçetin

https://doi.org/10.17941/agd.351685

Öz

Background and Aims:
Hypertriglyceridemia is an etiologic cause of acute pancreatitis, with a
frequency of 1%-5%. Insulin infusion, heparin infusion, and plasmapheresis can
be used for the treatment of acute pancreatitis related to
hypertriglyceridemia. The aim of our study was to share our experience with the
treatment, clinical course, and demographic features of patients with acute
pancreatitis related to hypertriglyceridemia and the effectiveness of
plasmapheresis. Material and Methods: Patients with
acute pancreatitis diagnosed and treated at Türkiye Yüksek İhtisas Training and
Research Hospital during 2014-2016 were screened. Those who had
hypertriglyceridemia with levels >900 mg/dl without any potential cause of
acute pancreatitis were included in the study as patients with
hypertriglyceridemia-induced acute pancreatitis. Medical data were collected
from patients’ files and the hospital computer automation system. Results: A total of 10
patients [male/female: 4/6, median age: 41.4 (26-51) years] were included in
the study. The frequency of acute pancreatitis was 1.4. The Bedside Index of
Severity in Acute Pancreatitis scoring system was used to establish the
severity of acute pancreatitis. Patients with a high Bedside Index of Severity
in Acute Pancreatitis score were treated with plasmapheresis (n=4). In this
group, three patients developed walled off necrosis and pseudocysts.
Percutaneous drainage was applied in one patient with walled off necrosis. No
mortality was observed in our patients. Conclusion:
Hypertriglyceridemia is a rare cause of acute pancreatitis. Early diagnosis and
appropriate treatment are important in this group for decreasing the
disease-related morbidity and mortality. Plasmapheresis is an effective
treatment modality, especially in patients with severe
hypertriglyceridemia-induced acute pancreatitis.

Anahtar Kelimeler

Acute pancreatitis, hypertriglyceridemia, plasmapheresis

Hipertrigliseridemiye bağlı akut pankreatitli hastalarımız ve plazmaferez deneyimimiz

Öz

Giriş ve Amaç: Akut pankreatitin %1-5 nedeni hipertrigliseridemidir.
İnsülin infüzyonu, heparin infüzyonu ve plazmaferez hipertrigliseridemiye bağlı
Akut pankreatitin tedavisinde yer almaktadır. Biz bu çalışmamızda
hipertrigliseridemiye bağlı oluşan Akut pankreatitli hastalarımızın demografik
özelliklerini, pankreatitlerinin seyrini, uygulanan tedavi yöntemlerini ve
plazmaferezin etkinliğini araştırdık. Gereç ve Yöntem: Türkiye Yüksek İhtisas Hastanesi Gastroenteroloji
Kliniği’nde 2012-2016 yılları arasında akut pankreatit tanısı konulan hastalar
retrospektif olarak tarandı. İlk başvuruda trigliserid değeri 900 mg/dl ve
üzeri olan hastalar, diğer etiyolojik nedenlerin yokluğunda
hipertrigliseridemiye bağlı Akut pankreatit olarak kabul edildi. Hastaların
medikal bilgilerine hasta dosyaları ve hastane otomasyon bilgi sisteminden
ulaşıldı. Bulgular: Toplam 10 hasta (E/K: 4/6, yaş ortalaması 41,4 (26-51)
çalışmaya alındı. Hastalarımızda akut pankreatit atak sıklığı 1,4 (1-3) olarak
bulundu. Akut pankreatit şiddetini belirlemede BISAP skorlaması kullanıldı.
BISAP skoru yüksek olan hastalara plasmaferez uygulandı (4 hasta). Bu
hastaların 3 tanesinde psödokist ve walled-off nekroz oluştuğu görüldü.
Walled-off nekroz oluşan bir hastaya perkütan drenaj yapıldı. Toplamda hiçbir
hastada mortalite izlenmedi. Sonuç: Hipertrigliseridemi, diğer nedenlere kıyasla akut
pankreatite nadiren yol açar. Bu hastaların erken tanınması ve uygun tedavisi
hastalık ilişkili morbidite ve mortalitenin azalmasına yol açar. Plazmaferez
özellikle ciddi seyreden hastalarda etkili bir tedavi yöntemidir.

Anahtar Kelimeler

Akut pankreatit, hipertrigliseridemi, plazmaferez

Kaynakça

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