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高甘油三酯血症引发急性胰腺炎:一例报告

Hypertriglyceridemia revealing acute pancreatitis: A case report.

作者信息

Ghizlane El Aidouni, Manal Merbouh, Salma Taouihar, Abderrahim El Kaouini, Mohammed Maarad, Ikram Zaid, Fatem-Zahra Aftiss, Sanae El Mezzioui, Houssam Bkiyar, Brahim Housni

机构信息

Intensive Care Unit, Mohammed VI University Hospital Center, Oujda, Morocco.

Mohammed First University Oujda, Faculty of Medicine and Pharmacy, Oujda, Morocco.

出版信息

Ann Med Surg (Lond). 2021 Oct 7;70:102914. doi: 10.1016/j.amsu.2021.102914. eCollection 2021 Oct.

Abstract

INTRODUCTION

Acute pancreatitis (AP) is considered one of the potentially rare complications of severe hypertriglyceridemia (HTG). Multiple treatment modalities have been suggested for patients with HTG-AP, such as permanent removal of TG by plasmapheresis, the use of insulin and heparin to enhance lipoprotein lipase activity and fibrate therapy, but the data remains limited.

CASE MANAGEMENT

we reported a case of 33-year-old women admitted for HTG-induced PA (HTG-AP). The patient had hypertriglyceridemia for 7 years under fibrate therapy as a medical history. On admission to our intensive care unit, his triglyceride level was 1060 mg/dl and the lipase level was 298 IU/L. An abdominal CT scan revealed stage E AP. The patient was treated with a low dose insulin infusion (0.05 unit/kg/h) with heparin and 5-day course of plasmapheresis, Fibrate therapy was maintained. His triglycerides went down to 130.9 mg/dl and she was discharged.

CONCLUSION

Early recognition of severe HTG can prevent progression to multiples diseases such as acute pancreatitis, can facilitate appropriate or even aggressive treatment to minimize complications of this.

摘要

引言

急性胰腺炎(AP)被认为是严重高甘油三酯血症(HTG)潜在的罕见并发症之一。对于HTG-AP患者,已提出多种治疗方式,如通过血浆置换永久去除甘油三酯、使用胰岛素和肝素增强脂蛋白脂肪酶活性以及贝特类药物治疗,但相关数据仍然有限。

病例管理

我们报告了一例33岁因HTG诱发胰腺炎(HTG-AP)入院的女性病例。该患者有7年高甘油三酯血症病史,一直在接受贝特类药物治疗。入住我们的重症监护病房时,其甘油三酯水平为1060mg/dl,脂肪酶水平为298IU/L。腹部CT扫描显示为E期AP。患者接受了低剂量胰岛素输注(0.05单位/千克/小时)联合肝素治疗以及为期5天的血浆置换,同时维持贝特类药物治疗。其甘油三酯水平降至130.9mg/dl后出院。

结论

早期识别严重HTG可预防进展为多种疾病,如急性胰腺炎,有助于进行适当甚至积极的治疗,以尽量减少其并发症。

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