Oliver Logan, Liu Chuchu, Sadowski Brett
Internal Medicine, Naval Medical Center San Diego, San Diego, USA.
Gastroenterology, Naval Medical Center San Diego, San Diego, USA.
Cureus. 2024 Jul 24;16(7):e65272. doi: 10.7759/cureus.65272. eCollection 2024 Jul.
Many etiologies of acute liver injury (ALI) include drug-induced liver injury (DILI), viral illness, and autoimmune disease. Acute pancreatitis is an uncommon though significant etiology of ALI caused by inflammation, fluid shifts, and ischemia secondary to microthrombi formation that can progress to liver failure if left untreated. We present a case of hypertriglyceridemia-induced pancreatitis resulting in liver injury-associated acute pancreatitis (LIAAP) and a concurrent consumptive coagulopathy consistent with an ischemic hepatopathy. Through treatment of her pancreatitis with intravenous insulin and plasmapheresis and subsequent transition to an oral regimen for her hypertriglyceridemia upon hospital discharge, the patient demonstrated full resolution of her ALI and coagulopathy. Through this case, we hope to highlight the importance of recognizing LIAAP and its underlying pathogenesis.
急性肝损伤（ALI）的病因众多，包括药物性肝损伤（DILI）、病毒性疾病和自身免疫性疾病。急性胰腺炎是ALI的一种不常见但重要的病因，由炎症、液体转移和继发于微血栓形成的缺血引起，如果不治疗可进展为肝衰竭。我们报告一例高甘油三酯血症性胰腺炎导致肝损伤相关性急性胰腺炎（LIAAP）以及并发与缺血性肝病相符的消耗性凝血病的病例。通过静脉注射胰岛素和血浆置换治疗其胰腺炎，并在出院后过渡到口服治疗方案以治疗其高甘油三酯血症，患者的ALI和凝血病完全缓解。通过这个病例，我们希望强调认识LIAAP及其潜在发病机制的重要性。
