ABSTRACT
BACKGROUND/AIM: Hypertriglyceridemia is rare and can provoke acute severe hyperlipidemic pancreatitis when triglyceride levels exceed 11.3 mmol/l. In 10 patients we evaluated the therapeutic guidelines for severe hyperlipidemic pancreatitis. METHODS: Ten patients (8 men and 2 women) were admitted to the intensive care unit with a diagnosis of acute severe hyperlipidemic pancreatitis. They underwent standard treatment. Heparin, insulin and antihyperlipidemic drugs were used to lower the triglyceride levels. The patients underwent plasmapheresis within 48 h of admission, and fat-free parenteral nutrition was used. Two of the patients underwent surgery because of infection of necrotic segments. RESULTS: Standard treatment was essential for all the patients but plasmapheresis was the procedure that lowered the triglyceride and lipid levels in all cases. It improved abdominal pain, clinical state, and signs and symptoms of the disease. Two patients underwent surgery due to infection of the necrotic segments and one of them died. Follow-up lasted 4-54 months with no recurrences of pancreatitis. CONCLUSION: Our study shows that standard treatment is essential, but plasmapheresis successfully lowered lipid levels with no complications and relieved the patients from the symptoms in the acute phase of the disease. Hyperlipidemic pancreatitis should initially be treated conservatively. Plasmapheresis is a method that has lately been used successfully for hyperlipidemic pancreatitis. It seems that all therapeutic measures should be applied as early as possible, within the first 48 h.
Subject(s)
Anticholesteremic Agents/adverse effects , Hyperlipidemias/complications , Pancreatitis, Acute Necrotizing/therapy , Parenteral Nutrition/methods , Plasmapheresis/methods , Adult , Aged , Anticholesteremic Agents/therapeutic use , Female , Follow-Up Studies , Humans , Hyperlipidemias/blood , Hyperlipidemias/drug therapy , Male , Middle Aged , Pancreatitis, Acute Necrotizing/blood , Pancreatitis, Acute Necrotizing/chemically induced , Retrospective Studies , Treatment Outcome , Triglycerides/bloodABSTRACT
BACKGROUND/AIM: Hyperlipidemic pancreatitis is an acute and potentially life-threatening complication of hypertriglyceridemia that can be provoked when triglyceride levels (TGL) exceed 11.3 mmol/l (1,000 mg/dl). Except for standard symptomatic treatment, plasmapheresis has been performed to rapidly reduce TGL and chylomicron levels in the blood. In 5 patients with hyperlipidemic pancreatitis, treatment with plasmapheresis was evaluated. METHODS: Five male patients who suffered from acute pancreatitis with severe primary hyperlipidemia were studied. In addition to the standard treatment, they were treated with plasmapheresis. RESULTS: Plasma exchange lowered the lipid level and TGLs in all cases. It also improved abdominal pain, the clinical state of the patients, and signs and symptoms of the disease. Complications of treatment were not encountered, none of the patients died and only 1 patient underwent surgery. Follow-up of the patients lasted 4-28 months, and recurrence of pancreatitis was not noted. CONCLUSION: Our study showed that plasmapheresis was successfully applied in patients with hyperlipidemic pancreatitis, especially to improve the acute phase of the disease.
Subject(s)
Hyperlipidemias/etiology , Hyperlipidemias/therapy , Pancreatitis/complications , Pancreatitis/therapy , Plasmapheresis , Acute Disease , Adult , Humans , Male , Middle Aged , Severity of Illness Index , Treatment OutcomeABSTRACT
The objective of this study was to investigate the relationship between alterations in the elasticity of the temporal and the renal arteries and the grade of arteriopathy, using the pulsatility index in type II diabetic patients and healthy volunteers. All individuals were divided into groups. Group A consisted of 15 patients without risk factors (hyperlipidemia, hypertension, obesity, and smoking) and had well-controlled diabetes mellitus as demonstrated by normal values of HbA1c. Group B had 20 patients with two risk factors (hyperlipidemia and hypertension) and normal HbA1c. Group C (25 patients) had four risk factors and high values of HbA1c, and group D consisted of 20 healthy individuals. All patients were examined by use of color Doppler ultrasonography. Pulsatility index values were measured in the temporal and renal arteries. Pulsatility indices of temporal arteries were higher in group C than in groups A and B, whereas for the renal arteries, no significant difference was detected between the four groups. In our study there seems to be strong correlation between increased values of pulsatility index, mainly in the temporal arteries, and grade of arteriopathy in type II diabetic patients.