Moderate Hypertriglyceridemia Causing Recurrent Pancreatitis: A Case Report and the Literature Review
Recurrent acute pancreatitis secondary to hypertriglyceridemia (HTG) with levels below 1000 mg/dL has been rarely reported in the literature. HTG is the third most common cause of acute pancreatitis and has been established in the literature as a risk factor when levels are greater than 1000 mg/dL....
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2018/8714390 |
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| author | Vijay Gayam Amrendra Kumar Mandal Pavani Garlapati Mazin Khalid Arshpal Gill Khalid Mowyad |
| author_facet | Vijay Gayam Amrendra Kumar Mandal Pavani Garlapati Mazin Khalid Arshpal Gill Khalid Mowyad |
| author_sort | Vijay Gayam |
| collection | DOAJ |
| description | Recurrent acute pancreatitis secondary to hypertriglyceridemia (HTG) with levels below 1000 mg/dL has been rarely reported in the literature. HTG is the third most common cause of acute pancreatitis and has been established in the literature as a risk factor when levels are greater than 1000 mg/dL. A 43-year-old patient presented to the hospital with severe epigastric abdominal pain. Initial laboratory investigations were significant for a lipase level of 4143 U/L and a triglyceride level of 600 mg/dL. Computed tomography (CT) of the abdomen showed diffuse enlargement of the pancreas consistent with pancreatitis. A diagnosis of severe acute pancreatitis secondary to high triglycerides was made based on the revised Atlanta classification 2012. The patient was initially managed with intravenous boluses of normal saline followed by continuous insulin infusion. Diabetic Ketoacidosis (DKA) was ruled out due to a past medical history of diabetes. Her clinical course was complicated by acute respiratory distress syndrome requiring intubation and mechanical ventilation. During the course, she improved symptomatically and was extubated. She was started on nasogastric feeding initially and subsequently switched to oral diet as tolerated. After initial management of HTG with insulin infusion, oral gemfibrozil was started for long-term treatment of HTG. Emerging literature implicates HTG as an independent indicator of poor prognosis in acute pancreatitis (AP). Despite the paucity of data, the risk of developing AP must be considered even at triglyceride levels lower than 1000 mg/dL. |
| format | Article |
| id | doaj-art-c8ff3e0beda1485d9207633205541df0 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
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| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-c8ff3e0beda1485d9207633205541df02025-02-03T06:12:39ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362018-01-01201810.1155/2018/87143908714390Moderate Hypertriglyceridemia Causing Recurrent Pancreatitis: A Case Report and the Literature ReviewVijay Gayam0Amrendra Kumar Mandal1Pavani Garlapati2Mazin Khalid3Arshpal Gill4Khalid Mowyad5Department of Medicine and Gastroenterology, Interfaith Medical Center, 1545 Atlantic Avenue, Brooklyn, NY, USADepartment of Medicine and Gastroenterology, Interfaith Medical Center, 1545 Atlantic Avenue, Brooklyn, NY, USADepartment of Medicine and Gastroenterology, Interfaith Medical Center, 1545 Atlantic Avenue, Brooklyn, NY, USADepartment of Medicine and Gastroenterology, Interfaith Medical Center, 1545 Atlantic Avenue, Brooklyn, NY, USADepartment of Medicine and Gastroenterology, Interfaith Medical Center, 1545 Atlantic Avenue, Brooklyn, NY, USADepartment of Medicine, Wayne State University/Detroit Medical Center, Detroit, MI, USARecurrent acute pancreatitis secondary to hypertriglyceridemia (HTG) with levels below 1000 mg/dL has been rarely reported in the literature. HTG is the third most common cause of acute pancreatitis and has been established in the literature as a risk factor when levels are greater than 1000 mg/dL. A 43-year-old patient presented to the hospital with severe epigastric abdominal pain. Initial laboratory investigations were significant for a lipase level of 4143 U/L and a triglyceride level of 600 mg/dL. Computed tomography (CT) of the abdomen showed diffuse enlargement of the pancreas consistent with pancreatitis. A diagnosis of severe acute pancreatitis secondary to high triglycerides was made based on the revised Atlanta classification 2012. The patient was initially managed with intravenous boluses of normal saline followed by continuous insulin infusion. Diabetic Ketoacidosis (DKA) was ruled out due to a past medical history of diabetes. Her clinical course was complicated by acute respiratory distress syndrome requiring intubation and mechanical ventilation. During the course, she improved symptomatically and was extubated. She was started on nasogastric feeding initially and subsequently switched to oral diet as tolerated. After initial management of HTG with insulin infusion, oral gemfibrozil was started for long-term treatment of HTG. Emerging literature implicates HTG as an independent indicator of poor prognosis in acute pancreatitis (AP). Despite the paucity of data, the risk of developing AP must be considered even at triglyceride levels lower than 1000 mg/dL.http://dx.doi.org/10.1155/2018/8714390 |
| spellingShingle | Vijay Gayam Amrendra Kumar Mandal Pavani Garlapati Mazin Khalid Arshpal Gill Khalid Mowyad Moderate Hypertriglyceridemia Causing Recurrent Pancreatitis: A Case Report and the Literature Review Case Reports in Gastrointestinal Medicine |
| title | Moderate Hypertriglyceridemia Causing Recurrent Pancreatitis: A Case Report and the Literature Review |
| title_full | Moderate Hypertriglyceridemia Causing Recurrent Pancreatitis: A Case Report and the Literature Review |
| title_fullStr | Moderate Hypertriglyceridemia Causing Recurrent Pancreatitis: A Case Report and the Literature Review |
| title_full_unstemmed | Moderate Hypertriglyceridemia Causing Recurrent Pancreatitis: A Case Report and the Literature Review |
| title_short | Moderate Hypertriglyceridemia Causing Recurrent Pancreatitis: A Case Report and the Literature Review |
| title_sort | moderate hypertriglyceridemia causing recurrent pancreatitis a case report and the literature review |
| url | http://dx.doi.org/10.1155/2018/8714390 |
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