Sevastru Stefan, Wakatsuki Mai, Fennell Jonathan, Grocott Michael P W
Critical Care Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
BMJ Case Rep. 2012 Aug 14;2012:bcr1120115208. doi: 10.1136/bcr.11.2011.5208.
The authors present a case of a young, non-diabetic Caucasian male patient with long-standing depression who had recently been started on venlafaxine. He presented to the emergency department with central abdominal pain, drowsiness and vomiting with a raised serum amylase. He was diagnosed with acute pancreatitis (AP) that was confirmed following an abdominal ultrasound and CT. His initial biochemistry was immeasurable in the first 12 h of admission due to macroscopically visible hyperlipidaemia. In the absence of any other causes of AP, hyperlipidaemia was the most likely aetiology. He was transferred to the intensive care unit where he was managed by lipidic restriction, fluid resuscitation and 3 consecutive days of plasma exchange. Plasma triglyceride levels were reduced from 42.9 to 2.4 mmol/l following plasma exchange. He made a full recovery and at discharge was investigated for familial hypertriglyceridaemia and referred to a multi-disciplinary team for follow-up. His venlafaxine was stopped on admission.
作者报告了一例年轻的非糖尿病白种男性患者，该患者长期患有抑郁症，近期开始服用文拉法辛。他因中上腹疼痛、嗜睡和呕吐伴血清淀粉酶升高而就诊于急诊科。经腹部超声和CT检查后，他被诊断为急性胰腺炎（AP）。由于肉眼可见的高脂血症，他入院后的最初12小时内生化指标无法测量。在没有其他AP病因的情况下，高脂血症是最可能的病因。他被转入重症监护病房，在那里接受了脂质限制、液体复苏和连续3天的血浆置换治疗。血浆置换后，血浆甘油三酯水平从42.9 mmol/L降至2.4 mmol/L。他完全康复，出院时接受了家族性高甘油三酯血症的检查，并被转介到多学科团队进行随访。他入院时停用了文拉法辛。
