Department of Pathology, Division of Transfusion Medicine, University of Texas Medical Branch, Galveston, Texas.
Department of Pediatrics, Division of Pediatric Endocrinology, University of Texas Medical Branch, Galveston, Texas.
Transfusion. 2019 Nov;59(11):3324-3328. doi: 10.1111/trf.15532. Epub 2019 Sep 30.
Familial chylomicronemia syndrome (FCS) is caused by a genetic defect in triglyceride (TG) metabolism that leads to severe hypertriglyceridemia, which in turn is associated with multiple morbidities and may cause severe pancreatitis that is both recurrent and progressive. Management of hypertriglyceridemia in FCS is challenging, as both dietary and medical interventions are often ineffective. Therapeutic plasma exchange (TPE) has been shown to rapidly decrease circulating levels of chylomicrons and TGs in patients presenting with acute hypertriglyceridemic-associated pancreatitis. Conversely, limited evidence exists to suggest that prophylactic use of TPE is effective at preventing recurrence of acute pancreatitis.
Herein, we report our experience with the use of chronic, prophylactic TPE to reduce the incidence of recurrent acute pancreatitis in a patient with FCS.
家族性乳糜微粒血症综合征(FCS)是由甘油三酯(TG)代谢的遗传缺陷引起的,导致严重的高甘油三酯血症,进而与多种疾病相关,并可能导致反复发作且进行性加重的严重胰腺炎。FCS 患者的高甘油三酯血症的治疗具有挑战性,因为饮食和药物干预通常都无效。已证明治疗性血浆置换(TPE)可迅速降低急性高甘油三酯血症相关胰腺炎患者的循环乳糜微粒和 TG 水平。相反,有限的证据表明预防性使用 TPE 可有效预防急性胰腺炎的复发。
在此,我们报告了我们使用慢性预防性 TPE 来降低 FCS 患者复发性急性胰腺炎发生率的经验。