Association of elevated serum triglyceride levels with a more severe course of acute pancreatitis: Cohort analysis of 1457 patients

Pancreatology ◽  
2019 ◽  
Vol 19 (5) ◽  
pp. 623-629 ◽  
Author(s):  
Isabel Pascual ◽  
Ana Sanahuja ◽  
Natalia García ◽  
Paola Vázquez ◽  
Oswaldo Moreno ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cohort Analysis ◽  
Elevated Serum ◽  
Serum Triglyceride

scholarly journals Diagnosis and Treatment of Acute Pancreatitis Due to Hypertriglyceridemia in Italy: A Survey among Physicians of the Italian Association for the Study of the Pancreas: A Brief Report

2020 ◽  
Vol 11 (2) ◽  
pp. 20-26
Author(s):  
Raffaele Pezzilli
Keyword(s):  
Acute Pancreatitis ◽  
Epigastric Pain ◽  
Imaging Techniques ◽  
Elevated Serum ◽  
Serum Triglyceride ◽  
New Drugs ◽  
Italian Association ◽  
Disease Definition ◽  
Definition Of ◽  
Epidemiological Characteristics

Introduction: The Italian Association for the Study of the Pancreas promoted a survey on exploring the point of view of Italian pancreatologists regarding the diagnosis and the treatment of acute pancreatitis (AP) due to hypertriglyceridemia (HAP). Method: A questionnaire was administered, and it contained four sections regarding epidemiological characteristics of the participants, how the participants arrived at a diagnosis of the disease, how they treated familial hypertriglyceridemia, and whether they knew of the new drugs developed for the treatment of this disease. Definition of AP and HAP: In this survey, all participants followed this definition of AP: The diagnosis of AP requires two of the following three features: abdominal pain consistent with acute pancreatitis (acute onset of a persistent and severe epigastric pain, often radiating to the back); serum pancreatic enzymes at least three times greater than the upper limit of normal; and characteristic findings of acute pancreatitis using imaging techniques. On the other hand, HAP is characterized by serum triglyceride concentration of >1000 mg/dL as the diagnostic cut-off, even though a value of >500 mg/dL has been used for a more inclusive definition, since moderately elevated triglyceride levels have also been suggested as a risk factor for AP. Results. Nine percent of all managed patients with AP had HAP; 5.0 ± 7.7 patients per year had a recurrence of HAP, and the number of recurrences was about one. A diagnosis of hypertriglyceridemia was made by the majority of Italian physicians due to the presence of elevated serum triglycerides at a level of ≥880 mg/dL. Twenty-five physicians treated their patients with fibrates, 23 with statins, 11 with omega-3, one with medium-chain triglycerides, and six with plasmapheresis. Finally, fewer than 50% of the physicians knew of the new drugs to treat dyslipidemia. Conclusions: The results of this survey show that an educational program is important, and we also need an Italian National Registry both for improving knowledge regarding this disease and for identifying the causal factors in our country.

scholarly journals SAT-577 Severe Asymptomatic Hypertriglyceridemia

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Daniel Rodriguez ◽  
Awa Drame
Keyword(s):  
Acute Pancreatitis ◽  
Case Reports ◽  
Elevated Serum ◽  
Serum Triglyceride ◽  
Lipid Lowering ◽  
Insulin Initiation ◽  
His Tag ◽  
High Lipid ◽  
Normal Triglyceride ◽  
Genetic Form

Abstract Background Case reports of patients with severely elevated serum triglyceride levels (>1000 mg/dL) have been documented where Insulin infusions, heparin and plasmapheresis have demonstrated rapid and successful decrease in serum Triglyceride levels. The benefits of one approach versus the other to prevent major complications such as cardiovascular events or acute pancreatitis has not been well investigated. We present the case of a patient with severely elevated serum triglyceride levels without any manifestations. Case Description A 53-year-old male presented from his primary care provider’s office due to elevated Triglycerides levels over 6000 as per outpatient lab work. Inpatient labs were unattainable initially due to hemolysis secondary to the severely high lipid content. Patient was admitted to the medical ICU for closer monitoring and initiated on an insulin drip. Two days after insulin initiation patient’s triglyceride levels returned as 2,887 with a total cholesterol count of 848. His insulin drip was continued until his TAG levels were less than 1000. Upon discharge his levels were less than 600. Discussion Most patients with hypertriglyceridemia are asymptomatic. However, in patients with levels above 1000 mg/dL, the risk of pancreatitis or cardiovascular event is of concern. Hypertriglyceridemia may account for 1 to 14 percent of cases of acute pancreatitis. Treatment is largely based upon symptoms and complications. In the event of pancreatitis or other cardiovascular complication, plasmapheresis is usually recommended. If asymptomatic, Insulin may be used. Insulin promotes synthesis of lipoprotein lipase which functions to hydrolyze triglycerides, and has been shown to be an effective lowering agent in the treatment of such individuals. Case reports of Heparin being used as a lipid lowering agent have also been documented, but was not used in our particular patient. Normal triglyceride plasma levels are defined as less than 150 mg/dL. Mild hypertriglyceridemia typically ranges between 150-499 mg/dL, moderate between 500-866 mg/dL, and severe is defined as levels greater than 886 mg/dL. Plasma triglyceride levels above 1000 mg/dL occur in fewer than 1 in 5000 individuals. It is said that patients with TAG levels above 2000 mg/dL almost always have both a secondary and a genetic form of Hypertriglyceridemia. For this reason it is very important to identify these patients as early as possible to treat appropriately. Our patient was a known alcohol abuser, yet without the presence of some polygenic familial disorder, the likelihood of our patient having TAG levels >6000 mg/dL, is very unlikely.

scholarly journals Elevated Serum Triglyceride Level as a Predictor of Local and Systemic Complications in Acute Pancreatitis

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S887-S888
Author(s):  
N.J. Hidalgo ◽  
E. Pando ◽  
P. Alberti ◽  
M.J. Gómez ◽  
R. Mata ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Triglyceride Level ◽  
Elevated Serum ◽  
Serum Triglyceride ◽  
Serum Triglyceride Level ◽  
Systemic Complications ◽  
Local And Systemic Complications

scholarly journals A case of acute pancreatitis with normal serum amylase and lipase value

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Jayanta Paul ◽  
Keyword(s):  
Acute Pancreatitis ◽  
Ct Scan ◽  
Acute Pain ◽  
Serum Amylase ◽  
Elevated Serum ◽  
Serum Triglyceride ◽  
Normal Serum ◽  
Upper Limit ◽  
Pain Abdomen ◽  
Rule Out

There are several causes of acute pancreatitis (AP). In clinical practice, AP is diagnosed by presence of acute pain abdomen, elevated serum amylase and lipase value (>3 times of upper limit of normal) and ultrasonographic (USG) findings of acute pancreatitis but in only 25-50% of patients with acute pancreatitis, pancreas is visualised. In this case, 44 years gentleman was presented with acute pain abdomen, normal serum amylase and lipase value and no pancreatic abnormality in abdominal USG. After diagnosis of elevated serum triglyceride, computed tomography (CT scan) of abdomen was done to exclude hypertriglyceridemia induced AP. CT scan abdomen showed features of acute pancreatitis. Therefore, in every patient with acute pain abdomen if serum amylase and lipase value and USG abdomen are normal, serum triglyceride should be advised to rule out hypertriglyceridemia induced AP. In this case report we are going to present a case of acute pancreatitis with normal serum amylase and lipase value.

Early occurrence of pseudocysts in acute pancreatitis – a multicenter international cohort analysis of 2275 acute pancreatitis cases

Pancreatology ◽  
2021 ◽  
Vol 21 ◽  
pp. S47-S48
Author(s):  
L. Szakó ◽  
A. Váradi ◽  
B. Tinusz ◽  
N. Vörhendi ◽  
D. Mosztbacher ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cohort Analysis ◽  
Early Occurrence

scholarly journals Primary Hyperparathyroidism due to Parathyroid adenoma presenting as recurrent acute pancreatitis

2017 ◽  
Vol 8 (1) ◽  
pp. 98-100
Author(s):  
Tarun J George ◽  
Pughazhendhi Thangavelu ◽  
S Zahir Hussain ◽  
MP Kumaran ◽  
Kini Ratnakar ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Elevated Serum ◽  
Surgical Excision ◽  
Medical Sciences ◽  
Thyroid Lobe ◽  
Recurrent Acute Pancreatitis ◽  
Hypoechoic Nodule ◽  
Left Thyroid Lobe

Primary hyperparathyroidism (PHPT) due to parathyroid adenoma presenting as recurrent acute pancreatitis is a rare entity. A 17-year-old male presented with recurrent attacks of pancreatitis and was found to have elevated serum calcium and Parathyroid hormone levels, 11.9mg/dL (8.5-10.2 mg/dL) and 396 pg/ml (10-65pg/ml) respectively. USG neck showed a 1.1 x 0.9 cm hypoechoic nodule in the superior aspect of left thyroid lobe. Parathyroid scintigraphy findings were consistent with parathyroid adenoma. After recovery of pancreatitis, surgical excision of the adenoma was done and the histopathological findings confirmed parathyroid adenoma. There were no further recurrence of pancreatitis following the excision.Asian Journal of Medical Sciences Vol.8(1) 2017 98-100

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