Ahmed Shaho F, Qadir Pshtiwan H, Ahmed Sasan M, Salih Karzan M, Abdulla Berwn A, Mohammed Hawbash R, Salih Abdulwahid M, Kakamad Fahmi H
Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
Ann Med Surg (Lond). 2022 Feb 24;75:103406. doi: 10.1016/j.amsu.2022.103406. eCollection 2022 Mar.
Acute pancreatitis (AP) is a serious inflammatory condition of the pancreas. Hypertriglyceridemia (HTG) is considered an uncommon cause of AP. The current study aims to present a unique case of recurrent seasonal severe HTG-induced AP (HTG-AP); treated with insulin and heparin.
A 36-year-old male presented with recurrent attacks of severe upper abdominal pain that was radiating to the back and associated with repeated vomiting. The condition has being occurring every autumn-winter for the last three years. He had thalassemia minor and had a history of HTG-AP. His TG levels were relatively normal from February to August; however, from September to February, his TG levels highly elevated which has resulted in HTG-AP every year for the past three years. The condition was confirmed via a contrast-enhanced computerized tomography scan of the abdomen. To prevent the next HTG-AP, his TG level was monitored monthly. When TG levels spiked again, the patient was put on an insulin infusion with heparin, glucose, and potassium to rapidly reduce TG level. After two days, serum TG was dramatically reduced (<500 mg/dL).
Despite multiple theories being proposed, the pathogenesis of HTG-AP is yet to be understood. Usually, HTG-AP is a single episodic, and recurrent HTG-AP is considered uncommon finding. Previous reports are contradictory regarding TG level and seasonal variation. There is currently no standard management approach to treat HTG-AP cases.
HTG-AP rarely reoccurs on an annual basis, and seasonal variation seems to play a major role in its onset. The condition can be managed with insulin, heparin, and glucose infusions.
急性胰腺炎（AP）是胰腺的一种严重炎症性疾病。高甘油三酯血症（HTG）被认为是AP的一种不常见病因。本研究旨在呈现一例复发性季节性严重HTG诱导的AP（HTG-AP）的独特病例；采用胰岛素和肝素进行治疗。
一名36岁男性出现反复的严重上腹部疼痛发作，疼痛放射至背部并伴有反复呕吐。在过去三年中，这种情况每年秋冬季节都会发生。他患有轻度地中海贫血，并有HTG-AP病史。他的甘油三酯水平在2月至8月相对正常；然而，从9月至次年2月，他的甘油三酯水平大幅升高，导致在过去三年中每年都发生HTG-AP。通过腹部增强计算机断层扫描确诊了该病情。为预防下一次HTG-AP，每月监测他的甘油三酯水平。当甘油三酯水平再次飙升时，患者接受胰岛素与肝素、葡萄糖和钾的静脉输注，以迅速降低甘油三酯水平。两天后，血清甘油三酯显著降低（<500mg/dL）。
尽管提出了多种理论，但HTG-AP的发病机制仍未明确。通常，HTG-AP是单次发作，而复发性HTG-AP被认为是不常见的发现。先前的报告在甘油三酯水平和季节变化方面存在矛盾。目前尚无治疗HTG-AP病例的标准管理方法。
HTG-AP很少每年复发，季节变化似乎在其发病中起主要作用。该病情可用胰岛素、肝素和葡萄糖输注进行管理。
