Bhuiyan Md, Pramanik Orin, Badar Faraz
Internal Medicine, Sharon Hospital and Nuvance Health, Sharon, USA.
Internal Medicine, Vassar Brothers Medical Center, Poughkeepsie, USA.
Cureus. 2023 Sep 2;15(9):e44567. doi: 10.7759/cureus.44567. eCollection 2023 Sep.
We present a rare case of a 52-year-old male with asymptomatic severe hypertriglyceridemia exceeding 11,000 mg/dL, managed initially with oral therapy without the need for an insulin drip or plasmapheresis. However, due to non-compliance at home, the patient subsequently developed pancreatitis requiring treatment with an insulin drip. He was discharged on a regimen of fenofibrate, rosuvastatin, and omega-3, with no further episodes of symptoms. Asymptomatic patients with severe hypertriglyceridemia and a low risk of developing symptoms can be safely managed through close monitoring, statin, fibrate therapy, and lifestyle modifications, but the risk of acute pancreatitis persists with elevated triglyceride levels of over 500 mg/dL and a marked increase in risk with a triglyceride level of greater than 880 mg/dL.
我们报告一例罕见病例，一名52岁男性患有无症状的严重高甘油三酯血症，甘油三酯水平超过11,000mg/dL，最初采用口服治疗，无需胰岛素静脉滴注或血浆置换。然而，由于患者在家中不依从治疗，随后发展为胰腺炎，需要胰岛素静脉滴注治疗。他出院时接受非诺贝特、瑞舒伐他汀和ω-3治疗方案，未再出现症状发作。无症状的严重高甘油三酯血症且发生症状风险较低的患者，可通过密切监测、他汀类药物、贝特类药物治疗和生活方式改变进行安全管理，但甘油三酯水平超过500mg/dL时急性胰腺炎风险持续存在，甘油三酯水平大于880mg/dL时风险显著增加。
