Costantini Nicoletta, Mameli Antonella, Marongiu Francesco
Dipartimento di Scienze Mediche Internistiche "M. Aresu" and Azienda Mista Ospedaliero-Universitaria, University of Cagliari, Cagliari, Italy.
Am J Ther. 2016 Jan-Feb;23(1):e288-91. doi: 10.1097/MJT.0000000000000079.
Severe hypertriglyceridemia is a common indication for the need of plasma exchange in treatment of hypertriglyceridemic-induced pancreatitis when normal therapies fail to garner a response. Application of plasmapheresis to prevent complication of hypertriglyceridemia is limited because of its cost and availability. We present a case of a 44-year-old man with metabolic syndrome and a medical history of secondary polycythemia in obesity hypoventilation syndrome, whose laboratory tests revealed a triglycerides value of 3965 mg/dL. To prevent the complication of pancreatitis due to hypertriglyceridemia, we performed plasma exchange 3 times when conventional treatments did not sufficiently reduce the high level of triglycerides. A review of the current available literature was therefore conducted to provide an overview of the present data on apheretic treatment for patients with severe hypertriglyceridemia. Several case reports and case series have used plasmapheresis in acute treatment of hypertriglyceridemia pancreatitis related. In our case, the choice of plasmapheresis was applied in prevention of possible complications of hypertriglyceridemia.
当常规治疗无效时,重度高甘油三酯血症是高甘油三酯血症性胰腺炎治疗中需要进行血浆置换的常见指征。由于血浆置换的成本和可及性,其在预防高甘油三酯血症并发症方面的应用受到限制。我们报告一例44岁男性患者,患有代谢综合征,有肥胖低通气综合征继发红细胞增多症病史,其实验室检查显示甘油三酯值为3965mg/dL。为预防高甘油三酯血症所致胰腺炎的并发症,在常规治疗未能充分降低高水平甘油三酯时,我们进行了3次血浆置换。因此,我们对当前可用文献进行了综述,以概述目前关于重度高甘油三酯血症患者血液净化治疗的数据。几例病例报告和病例系列研究已将血浆置换用于与高甘油三酯血症性胰腺炎相关的急性治疗。在我们的病例中,血浆置换的选择是用于预防高甘油三酯血症可能的并发症。