White River Health System, Batesville, AR, USA.
J Investig Med High Impact Case Rep. 2020 Jan-Dec;8:2324709620940492. doi: 10.1177/2324709620940492.
A 28-year-old female presented to the emergency room with epigastric pain, nausea, and vomiting; her lipase was elevated, and computed tomography of abdomen showed evidence of acute pancreatitis. Her past medical history was significant for poorly controlled insulin requiring type 2 diabetes mellitus and 2 previous admissions for hypertriglyceridemia-induced pancreatitis. Due to the severity of her pancreatitis presentation, she was admitted to the intensive care unit. She received aggressive intravenous fluid hydration and was started on an insulin drip. Apheresis was strongly considered given the degree of her hypertriglyceridemia (11 602 mg/dL), but there was no timely access to this treatment option. She, however, significantly improved with insulin therapy alone. Her triglyceride levels decreased rather quickly to 4783 mg/dL within 24 hours and by the fourth day of admission were comfortably <1000 mg/dL with insulin infusion along with clinical improvement. She was discharged on niacin and insulin therapy along with her home medications of statin and fenofibrate.
一位 28 岁女性因上腹痛、恶心和呕吐到急诊就诊；她的脂肪酶升高，腹部计算机断层扫描显示有急性胰腺炎的证据。她的既往病史包括控制不佳的需要胰岛素治疗的 2 型糖尿病和 2 次因高甘油三酯血症引起的胰腺炎住院治疗。由于她的胰腺炎表现严重，她被收入重症监护病房。她接受了积极的静脉补液治疗，并开始接受胰岛素滴注。由于她的高甘油三酯血症程度严重（11602mg/dL），强烈考虑进行血浆分离，但没有及时获得这种治疗选择。然而，她仅用胰岛素治疗就明显好转。她的甘油三酯水平在 24 小时内迅速降至 4783mg/dL，入院第 4 天，随着临床症状的改善，胰岛素输注使甘油三酯水平降至 1000mg/dL 以下，且患者情况舒适。她出院时继续使用烟酸和胰岛素治疗，同时还服用她的他汀类药物和非诺贝特类药物。
