Pediatrics, University of Michigan Health - Sparrow, Lansing, Michigan, USA.
Pediatrics - PICU, University of Michigan Health - Sparrow, Lansing, Michigan, USA.
BMJ Case Rep. 2024 Aug 14;17(8):e257587. doi: 10.1136/bcr-2023-257587.
Hypertriglyceridaemia-induced acute pancreatitis (HTG-AP) remains one of the common metabolic causes of acute pancreatitis in the paediatric population and the third most common cause after alcohol and gallstones in the adult population. We report a case of an early adolescent girl with global developmental delay and moderate cognitive impairment of unknown aetiology who presented with recurrent acute pancreatitis and uncompensated hypovolaemic shock. She was found to have serum triglyceride level of 7877 mg/dL (reference range<150 mg/dL) and hyperglycaemia with ketosis (no prior history of diabetes mellitus) that was successfully treated with lipid apheresis. This sometimes is an early modality for treatment in adults; however, it remains a last resort in children, used only for severe cases. A brief literature review on severe HTG-AP and its management is also provided.
高甘油三酯血症性急性胰腺炎(HTG-AP)仍然是儿科人群中常见的代谢性急性胰腺炎病因之一,也是成年人中仅次于酒精和胆结石的第三大常见病因。我们报告了一例患有全球发育迟缓且认知功能中度受损的青少年女孩,其病因不明,表现为反复发作的急性胰腺炎和代偿性低血容量性休克。该患者的血清甘油三酯水平为 7877mg/dL(参考范围<150mg/dL),伴有高血糖和酮症(无糖尿病史),经脂质吸附治疗后得到成功控制。这种方法有时是成人治疗的早期手段;然而,在儿童中仍然是最后的手段,仅用于严重病例。本文还简要回顾了严重 HTG-AP 及其治疗方法。