Liu Rongfei, Lu Jiamin, Zhang Duo, Lu Wei, Yu Zizhou, Shao Xupeng, Xie Na, Duan Liyun, Xing Shuai, Wang Xiaoyue, Zhao Xue, Lv Peng, Fan Kailiang
First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Department of Emergency Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Am J Case Rep. 2024 Dec 21;25:e944763. doi: 10.12659/AJCR.944763.
BACKGROUND Hypertriglyceridemia (HTG) is associated with circulating free fatty acids that can cause acute pancreatitis. Therapeutic plasma exchange (TPE) is a rapid and effective method of reducing triglyceride levels. This case series presents 6 cases of acute pancreatitis associated with hypertriglyceridemia with a rapid response to therapeutic plasma exchange. CASE REPORT Six patients diagnosed with hypertriglyceridemia-induced acute pancreatitis (HTG-AP) were hospitalized and received therapeutic plasma exchange at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine. Upon admission, laboratory tests and abdominal computed tomography (CT) were performed, and all signs and test results were consistent with the diagnosis of hypertriglyceridemia and acute pancreatitis (AP). Among them, 4 patients were discharged after therapeutic plasma exchange. Anaphylaxis and ketoacidosis occurred in 2 cases during therapeutic plasma exchange. CONCLUSIONS High levels of triglyceride can lead to acute pancreatitis events. After therapeutic plasma exchange treatment for hypertriglyceridemia-induced acute pancreatitis, triglyceride levels decrease significantly, and adverse reactions during therapeutic plasma exchange should be actively watched for. However, there are no clear criteria for applying therapeutic plasma exchange, and more studies are needed to assess the value and risks of this treatment option. This case series shows the importance of evaluating triglyceride levels in patients with acute pancreatitis and the role of therapeutic plasma exchange.
背景 高甘油三酯血症（HTG）与可导致急性胰腺炎的循环游离脂肪酸有关。治疗性血浆置换（TPE）是降低甘油三酯水平的一种快速有效的方法。本病例系列介绍了6例与高甘油三酯血症相关的急性胰腺炎患者，其对治疗性血浆置换反应迅速。病例报告 6例被诊断为高甘油三酯血症诱导的急性胰腺炎（HTG-AP）的患者入住山东中医药大学附属医院并接受了治疗性血浆置换。入院时进行了实验室检查和腹部计算机断层扫描（CT），所有体征和检查结果均与高甘油三酯血症和急性胰腺炎（AP）的诊断一致。其中，4例患者在接受治疗性血浆置换后出院。2例患者在治疗性血浆置换期间发生过敏反应和酮症酸中毒。结论 高水平的甘油三酯可导致急性胰腺炎事件。对高甘油三酯血症诱导的急性胰腺炎进行治疗性血浆置换治疗后，甘油三酯水平显著降低，应积极关注治疗性血浆置换期间的不良反应。然而，应用治疗性血浆置换尚无明确标准，需要更多研究来评估这种治疗选择的价值和风险。本病例系列显示了评估急性胰腺炎患者甘油三酯水平的重要性以及治疗性血浆置换的作用。
