Treatment of hypertriglyceridemia-induced acute pancreatitis with plasmapheresis

Yıl 2012, , - , 01.12.2012

Gülbanu Erkan( Esat Kıvanç Kaya() Fatma Betül Polat() Bülent Değertekin( Gökçe Kaan Ataç() Güldane Cengiz Seval() Meltem Aylı() Ahmet Çorakcı() Halil Değertekin(

https://doi.org/10.17940/endoskopi.74826

Öz

The pancreas. The clinical pre-sentation may vary from edematous pancreatitis, a milder form, to necroti-zing pancreatitis, which has an unfavorable clinical course. The most com-mon etiological agents are bile stones and alcohol. Hypertriglyceridemia can also cause acute pancreatitis. The risk of acute pancreatitis increases when se­rum triglyceride levels exceed 1000 mg/L. Herein, we present a case wth type I familial hyperlipidemia who presented with hypertriglyceridemia-induced acute pancreatitis, which did not respond to conservative treatment but only abated after plasmapheresis.

Anahtar Kelimeler

Acute pancreatitis, hypertriglyceridemia, plasmapheresis

Hipertrigliseridemiye bağlı akut pankreatit tedavisinde plazmaferez

Öz

Akut pankreatit pankreasın akut inflamasyonudur. Hastalığın hafif bir şekli olan ödematöz pankreatitten, ağır bir klinikle seyreden nekrotizan pankreati-te kadar farklı klinik şekillerde prezente olabilir. Etyolojide en sık sebep, saf­ra taşları ve alkoldür. Hipertrigliseridemi de akut pankreatite yol açabilir. Se­rum trigliserid düzeyi 1000 mgr/dl ve üstüne çıktığında akut pankreatit riski artar. Biz Tip I ailevi hiperlipidemisi olan, hipertrigliseridemiye bağlı akut pankreatitle başvuran, konservatif tedaviye rağmen akut pankreatit tablosu yatışmayan ve plazmaferez ile klinik düzelme sağlanan bir olgu sunacağız.

Anahtar Kelimeler

Akut pankreatit, hipertrigliseridemi, plazmaferez

Kaynakça

• Fortson MR, Freedman SN, Webster PD 3rd. Clinical assessment of hyperlipidemic pancreatitis. Am J Gastroenterol 1995;90:2134-9.
• Toskes PP. Hyperlipidemic pancreatitis. Gastroenterol Clin North Am 1990;19:783-91.
• Fallat RW, Vester JW, Glueck CJ. Suppression of amylase activity by hypertriglyceridemia. JAMA 1973;225:1331-4.
• Tsuang W, Navaneethan U, Ruiz L, et al. Hypertriglyceridemic pancre- atitis: presentation and management. Am J Gastroenterol 2009;104:984- 91.
• Yadav D, Pitchumoni CS. Issues in hyperlipidemic pancreatitis. J Clin Gastroenterol 2003;36:54-62.
• Fredrickson DS. An international classification of hyperlipidemias and hyperlipoproteinemias. Ann Intern Med 1971;75:471-2.
• Goldenberg NM, Wang P, Glueck CJ. An observational study of severe hypertriglyceridemia, hypertriglyceridemic acute pancreatitis, and failu- re of triglyceride-lowering therapy when estrogens are given to women with and without familial hypertriglyceridemia. Clin Chim Acta 2003;332:11-9.
• Navarro S, Cubiella J, Feu F, et al. Hypertriglyceridemic acute pancreati- tis. Is its clinical course different from lithiasic acute pancreatitis?. Med Clin (Barc) 2004;123:567-70.
• Alagözlü H, Cindoruk M, Karakan T, ve ark. Heparin and insulin in the treatment of hypertriglyceridemia-induced severe acute pancreatitis. Dig Dis Sci 2006;51:931-3.
• Kyriakidis AV, Karydakis P, Neofytou N, et al. Plasmapheresis in the ma- nagement of acute severe hyperlipidemic pancreatitis: report of 5 cases. Pancreatology. 2005;5:201-4.