Case Report
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Hipertrigliseridemiye Sekonder Pankreatit: Bir Olgu Sunumu

Year 2020, Volume: 5 Issue: 3, 43 - 47, 01.12.2020

Abstract

Akut pankreatit, pankreasın çok yaygın bir enflamatuar durumudur. Akut pankreatit vakalarının çoğuna safra taşları veya alkol neden olur. Bununla birlikte, pankreatitin bir başka yaygın, ancak sıklıkla gözden kaçan nedeni hiperlipidemidir, özellikle hipertrigliseridemidir. Ailesel hiperlipidemi öyküsü olan ve şiddetli akut pankreatit ile başvuran 45 yaşında bir beyefendinin olgusunu sunuyoruz. Sunumda laboratuvar hiperlipidemisinin şiddeti nedeniyle kan örneğini işleyemedi. İntravenöz insülin ile tedaviye başlandıktan sonra laboratuar incelemeleri şiddetli hipertrigliseridemi gösterdi. Bu vakayı takiben hipertrigliseridemiye bağlı akut pankreatit için farklı tedavi modalitelerini tartışacağız.

References

  • Reference 1 Toskes PP. Hyperlipidemic pancreatitis. Gastroenterol Clin North Am. 1990;19:783-791.
  • Reference 2 Crockett SD, Wani S, Gardner TB, Falck-ytter Y, Barkun A. American Gastroenterological Association Institute Guideline on initial management of acute pancreatitis. Gastroenterology 154(4):1096-1101, 2018.
  • Reference 3 Liu NJ, Chapman R, Lin Y, Bentham A, Tyreman M, Philips N, Khanc SA, Stevens MM. Phospholipase A2 as a point of care alternative to serum amylase and pancreatic lipase. Nanoscale 8(23):11834-11839, 2016.
  • Reference 4 Khatua B, El-kurdi B, Singh VP. Obesity and pancreatitis. Curr Opin Gastroenterol 33(5):374-382, 2017.
  • Reference 5 Dominguez-Muñoz JE, Malfertheiner P, Ditschuneit HH, Blanco-Chavez J, Uhl W, Büchler M, Ditschuneit H. Hyperlipidemia in acute pancreatitis. Relationship with etiology, onset, and severity of the disease. Int J Pancreatol. 1991;10:261-267.
  • Reference 6 Tsuang, W., Navaneethan, U., Ruiz, L., Palascak, J. and Gelrud, A., 2009. Hypertriglyceridemic Pancreatitis: Presentation and Management. The American Journal of Gastroenterology, 104(4), pp.984-991.
  • Reference 7 Lithell H, Vessby B, Walldius G, Carlson LA. Hypertriglyceridemia--acute pancreatitis--ischemic heart disease. A case study in a pair of monozygotic twins. Acta Med Scand. 1987;221:311-316.
  • Reference 8 Guo, Y., 2020. Hypertriglyceridemia-Induced Acute Pancreatitis: Progress On Disease Mechanisms And Treatment Modalities. [online] Discovery Medicine. Available at: <https://www.discoverymedicine.com/Yao-Yao-Guo/2019/02/hypertriglyceridemia-induced-acute-pancreatitis-disease-mechanisms-treatment-modalities/> [Accessed 25 July 2020].
  • Reference 9 Garg R, Rustagi T. Management of hypertriglyceridemia induced acute pancreatitis. Biomed Res Int 2018:4721357, 2018.
  • Reference 10 Raeven GM. Pathophysiology of insulin resistance in human disease. Physiol Rev. 1995; 75: 473-486.
  • Reference 11 Bosques-Padilla FJ, Vázquez-Elizondo G, González-Santiago O, Follo-Martínez L, González OP, González-González JA, Garza-González E. Hypertriglyceridemia-induced pancreatitis and risk of persistent systemic inflammatory response syndrome. Am J Med Sci 349(3):206-211, 2015.
  • Reference 12 Li X, Ke L, Dong J, Ye B, Meng L, Mao W, Yang Q, Li W, Li J. Significantly different clinical features between hypertriglyceridemia and biliary acute pancreatitis : a retrospective study of 730 patients from a tertiary center. BMC Gastroenterol 18(1):1-8, 2018.
  • Reference 13 Searles GE, Ooi TC. Underrecognition of chylomicronemia as a cause of acute pancreatitis. CMAJ. 1992;147:1806-1808
  • Reference 14 Saharia P, Margolis S, Zuidema GD, Cameron JL. Acute pancreatitis with hyperlipemia: studies with an isolated perfused canine pancreas. Surgery. 1977;82:60-67
  • Reference 15 Scherer J, Singh VP, Pitchumoni CS, Yadav D. Issues in hypertriglyceridemic pancreatitis: an update. J Clin Gastroenterol. 2014;48(3):195–203.
  • Reference 16 Berger Z, Quera R, Poniachik J. et al. Heparin and insulin treatment of acute pancreatitis caused by hypertriglyceridemia. Experience of 5 cases. Rev Med Chil. 2001; 129(12): 1373-1378
  • Reference 17 Yeh JH, Chen JH, Chiu HC. Plasmapheresis for hyperlipidemic pancreatitis. J Clin Apheresis. 2003; 18(4): 181-185.
  • Reference 18 Khan R, Jehangir W, Regeti K, Yousif A. Hypertriglyceridemia-induced pancreatitis: choice of treatment. Gastroenterology Res. 2015;8(3–4):234–6
  • Reference 19 He WH, Yu M, Zhu Y, Xia L, Liu P, Zeng H, Zhu Y, Lv NH. Emergent triglyceride-lowering therapy with early high-volume hemofiltration against low-molecular-weight heparin combined with insulin in hypertriglyceridemic pancreatitis: a prospective randomized controlled trial. J Clin Gastroenterol. 2016;50(9):772–8
  • Reference 20 Gan, S., 2006. Hypertriglyceridemia-induced pancreatitis: A case-based review. World Journal of Gastroenterology, 12(44), p.7197.

Pancreatitis Secondary to Hypertriglyceridemia: A Case Report

Year 2020, Volume: 5 Issue: 3, 43 - 47, 01.12.2020

Abstract

Acute pancreatitis is a very common inflammatory condition of the pancreas. Most cases of acute pancreatitis are caused by either biliary stones or alcohol. However, another common but often under looked cause of pancreatitis is hyperlipidemia, specifically, hypertriglyceridemia. We present the case of a 45 year old gentleman with a history of familial hyperlipidemia who presented with severe acute pancreatitis. On presentation the lab was unable to process his blood sample due to the severity of his hyperlipidemia. After treatment was initiated with intravenous insulin lab investigations showed severe hypertriglyceridemia. We will discuss this case followed by the different treatment modalities for hypertriglyceridemia induced acute pancreatitis.

References

  • Reference 1 Toskes PP. Hyperlipidemic pancreatitis. Gastroenterol Clin North Am. 1990;19:783-791.
  • Reference 2 Crockett SD, Wani S, Gardner TB, Falck-ytter Y, Barkun A. American Gastroenterological Association Institute Guideline on initial management of acute pancreatitis. Gastroenterology 154(4):1096-1101, 2018.
  • Reference 3 Liu NJ, Chapman R, Lin Y, Bentham A, Tyreman M, Philips N, Khanc SA, Stevens MM. Phospholipase A2 as a point of care alternative to serum amylase and pancreatic lipase. Nanoscale 8(23):11834-11839, 2016.
  • Reference 4 Khatua B, El-kurdi B, Singh VP. Obesity and pancreatitis. Curr Opin Gastroenterol 33(5):374-382, 2017.
  • Reference 5 Dominguez-Muñoz JE, Malfertheiner P, Ditschuneit HH, Blanco-Chavez J, Uhl W, Büchler M, Ditschuneit H. Hyperlipidemia in acute pancreatitis. Relationship with etiology, onset, and severity of the disease. Int J Pancreatol. 1991;10:261-267.
  • Reference 6 Tsuang, W., Navaneethan, U., Ruiz, L., Palascak, J. and Gelrud, A., 2009. Hypertriglyceridemic Pancreatitis: Presentation and Management. The American Journal of Gastroenterology, 104(4), pp.984-991.
  • Reference 7 Lithell H, Vessby B, Walldius G, Carlson LA. Hypertriglyceridemia--acute pancreatitis--ischemic heart disease. A case study in a pair of monozygotic twins. Acta Med Scand. 1987;221:311-316.
  • Reference 8 Guo, Y., 2020. Hypertriglyceridemia-Induced Acute Pancreatitis: Progress On Disease Mechanisms And Treatment Modalities. [online] Discovery Medicine. Available at: <https://www.discoverymedicine.com/Yao-Yao-Guo/2019/02/hypertriglyceridemia-induced-acute-pancreatitis-disease-mechanisms-treatment-modalities/> [Accessed 25 July 2020].
  • Reference 9 Garg R, Rustagi T. Management of hypertriglyceridemia induced acute pancreatitis. Biomed Res Int 2018:4721357, 2018.
  • Reference 10 Raeven GM. Pathophysiology of insulin resistance in human disease. Physiol Rev. 1995; 75: 473-486.
  • Reference 11 Bosques-Padilla FJ, Vázquez-Elizondo G, González-Santiago O, Follo-Martínez L, González OP, González-González JA, Garza-González E. Hypertriglyceridemia-induced pancreatitis and risk of persistent systemic inflammatory response syndrome. Am J Med Sci 349(3):206-211, 2015.
  • Reference 12 Li X, Ke L, Dong J, Ye B, Meng L, Mao W, Yang Q, Li W, Li J. Significantly different clinical features between hypertriglyceridemia and biliary acute pancreatitis : a retrospective study of 730 patients from a tertiary center. BMC Gastroenterol 18(1):1-8, 2018.
  • Reference 13 Searles GE, Ooi TC. Underrecognition of chylomicronemia as a cause of acute pancreatitis. CMAJ. 1992;147:1806-1808
  • Reference 14 Saharia P, Margolis S, Zuidema GD, Cameron JL. Acute pancreatitis with hyperlipemia: studies with an isolated perfused canine pancreas. Surgery. 1977;82:60-67
  • Reference 15 Scherer J, Singh VP, Pitchumoni CS, Yadav D. Issues in hypertriglyceridemic pancreatitis: an update. J Clin Gastroenterol. 2014;48(3):195–203.
  • Reference 16 Berger Z, Quera R, Poniachik J. et al. Heparin and insulin treatment of acute pancreatitis caused by hypertriglyceridemia. Experience of 5 cases. Rev Med Chil. 2001; 129(12): 1373-1378
  • Reference 17 Yeh JH, Chen JH, Chiu HC. Plasmapheresis for hyperlipidemic pancreatitis. J Clin Apheresis. 2003; 18(4): 181-185.
  • Reference 18 Khan R, Jehangir W, Regeti K, Yousif A. Hypertriglyceridemia-induced pancreatitis: choice of treatment. Gastroenterology Res. 2015;8(3–4):234–6
  • Reference 19 He WH, Yu M, Zhu Y, Xia L, Liu P, Zeng H, Zhu Y, Lv NH. Emergent triglyceride-lowering therapy with early high-volume hemofiltration against low-molecular-weight heparin combined with insulin in hypertriglyceridemic pancreatitis: a prospective randomized controlled trial. J Clin Gastroenterol. 2016;50(9):772–8
  • Reference 20 Gan, S., 2006. Hypertriglyceridemia-induced pancreatitis: A case-based review. World Journal of Gastroenterology, 12(44), p.7197.
There are 20 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Olgu Sunumu
Authors

Abdul Karim Arida This is me 0000-0001-6160-5693

Omar Khaddam 0000-0003-3477-1869

Sara Alnaher 0000-0002-7679-6565

Ashraf Elghul This is me 0000-0003-0960-5543

Publication Date December 1, 2020
Acceptance Date October 28, 2020
Published in Issue Year 2020 Volume: 5 Issue: 3

Cite

Vancouver Arida AK, Khaddam O, Alnaher S, Elghul A. Pancreatitis Secondary to Hypertriglyceridemia: A Case Report. JAMER. 2020;5(3):43-7.