Журнал клинических случаев

Severe Hypertriglyceridemia-Induced Pancreatitis in Young Female Managed with Plasmapharesis: A Case Report

Abstract

Ahmed A Khalifa, Sheref A Elseidy and Ahmed M Khalifa

Background: Hypertriglyceridemia (HTG) is postulated to be a rare cause of acute pancreatitis accounting for approximately 4% of causes. A serum triglyceride (TG) level above 1,000 mg/dl in the setting of pancreatitis and absent of other major causes is necessary to describe hypertriglyceridemia as a cause of acute pancreatitis. The mechanism involves the degradation of triglycerides by pancreatic lipase to release free fatty acids that induces free radical damage to the tissues. The major cornerstone in management is by reducing the triglyceride level to below 1000 mg/dL to achieve both the subsidal of the ongoing attack and the effective prevention of further episodes of pancreatitis. This can be achieved by a spectrum of treatment modalities ranging from includes dietary restriction of fat, administration of lipid-lowering agents to Experiences with plasmapheresis and effective lipid pharesis however, the latter modality hasn’t been sufficiently discussed regarding therapeutic effects.
Case presentation: This case reports a young female, 22-year-old female patient non-alcoholic, non-diabetic, non-obese with negative history for gall stones or significant drug use diagnosed with hypertriglyceridemic acute pancreatitis associated with acute kidney injury, and received one session of hemodialysis then plasmapharesis was initiated and she received 8 sessions with full dose of hypolipidemics, and responded only to plasmapharesis.