Singla Animesh A, Ting Francis, Singla Apresh
University of New South Wales. Kensington, NSW, Australia.
JOP. 2015 Mar 20;16(2):201-4. doi: 10.6092/1590-8577/2961.
The triad of acute pancreatitis, hypertriglyceridemia and diabetes is a rare occurrence.
A previously well 19-year-old male presented to the emergency department with 24-hour history of epigastric pain, associated with polyuria and nausea. Biochemical markers showed the presence of hyperglycemia (blood sugar level 15 mmol/L) and ketonemia (5.3 mmol/L). Further investigation revealed severe hypertriglyceridemia (4,009 mg/dL) and elevated lipase (1,714 U/L). Abdominal ultrasound confirmed the diagnosis of acute pancreatitis. He was transferred to intensive care, where he received i.v. hydration, insulin and dextrose infusion. His metabolic derangements gradually resolved. His glycosylated hemoglobin was 13%, indicating the presence of chronically elevated blood sugars.
The possible pathophysiology and management of this unusual triad: diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis, are explored in this paper.
急性胰腺炎、高甘油三酯血症和糖尿病三联征较为罕见。
一名既往健康的19岁男性因上腹部疼痛24小时、伴有多尿和恶心就诊于急诊科。生化指标显示存在高血糖（血糖水平15 mmol/L）和酮血症（5.3 mmol/L）。进一步检查发现严重高甘油三酯血症（4,009 mg/dL）和脂肪酶升高（1,714 U/L）。腹部超声确诊为急性胰腺炎。他被转入重症监护室，在那里接受静脉补液、胰岛素和葡萄糖输注。他的代谢紊乱逐渐得到缓解。他的糖化血红蛋白为13%，表明存在长期血糖升高情况。
本文探讨了这种不寻常三联征（糖尿病酮症酸中毒、高甘油三酯血症和急性胰腺炎）可能的病理生理学及治疗方法。
