Contreras-Bolívar Victoria, González-Molero Inmaculada, Valdivieso Pedro, Olveira Gabriel
UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga. IBIMA. Universidad de Málaga..
UGC Medicina Interna, Hospital Virgen de la Victoria. IBIMA. Universidad de Málaga. España..
Nutr Hosp. 2015 Oct 1;32(4):1837-40. doi: 10.3305/nh.2015.32.4.9608.
We present a case of severe acute pancreatitis induced by hypertriglyceridemia secondary to lipoprotein lipase (LPL) deficiency in a pregnant patient with gestational diabetes, initially maneged with diet but it was later necessary to carry out artificial nutricional support measures: total parenteral nutrition. LPL deficiency might cause severe hypertriglyceridemia, repetition acute pancreatitis which is an unwieldy and severe situation during pregnancy. Acute familial hypertriglyceridemia pancreatitis accounts for 5% of cases, including LPL deficiency. The goal of treatment is to reach triglycerides levels below 500 mg/dl, being very low fat diet the treatment of choice, drugs or plasmapheresis techniques can also be associated. TPN enriched in ω3 fatty acids and glutamine was safe and effective in our patient with significant decrease in triglyceride levels.
我们报告一例妊娠糖尿病孕妇因脂蛋白脂肪酶（LPL）缺乏继发高甘油三酯血症导致的严重急性胰腺炎病例，最初采用饮食管理，但后来有必要采取人工营养支持措施：全胃肠外营养。LPL缺乏可能导致严重的高甘油三酯血症、复发性急性胰腺炎，这在孕期是一种棘手且严重的情况。急性家族性高甘油三酯血症性胰腺炎占病例的5%，包括LPL缺乏。治疗目标是使甘油三酯水平降至500mg/dl以下，极低脂肪饮食是首选治疗方法，也可联合使用药物或血浆置换技术。富含ω3脂肪酸和谷氨酰胺的全胃肠外营养对我们的患者是安全有效的，甘油三酯水平显著下降。
