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Revista colombiana de Gastroenterología
Print version ISSN 0120-9957
Abstract
MARIN S, Juliana; JIMENEZ S, Héctor Conrado and RAMIREZ CH, Claudia Marcela. Severe acute pancreatitis due to hypertriglyceridemia in adults: Clinical case presentation, diagnosis and treatment. Rev Col Gastroenterol [online]. 2018, vol.33, n.4, pp.459-463. ISSN 0120-9957. https://doi.org/10.22516/25007440.315.
Pancreatitis is one of the most frequent gastrointestinal causes of hospital admission. In 2009, it accounted for more than 275,000 admissions to emergency departments in the United States. (1) Hypertriglyceridemia is the third most frequent cause of pancreatitis, and triglyceride levels over 1,000 mg/dl are considering to indicate high risk for its development. (2) This group of patients has a worse prognosis than those with pancreatitis of other etiologies, but to date, no clear standard definition of how the range of triglyceride levels is related to the severity of acute pancreatitis has been defined.
There are several pathophysiological mechanisms that explain the onset of pancreatitis in the context of hypertriglyceridemia. One of the best studied is the toxic role of free fatty acids on pancreatic tissue. (3) Another widely accepted mechanism is vascular obstruction mediated by chylomicrons given the decrease in the genetic expression of lipoprotein lipase (LPL). (4)
Successful treatment of this disease is based on lowering triglyceride levels below 500 mg/dl. One fast and effective tool for achieving this is plasmapheresis.
Keywords : Acute pancreatitis; triglycerides; plasmapheresis.