Hypertriglyceridemia-induced acute pancreatitis: clinical considerations

Abstract

Editorial"Severe hypertriglyceridemia is associated with increased risk of acute pancreatitis. The clinical manifestation and prognosis of hypertriglyceridemia-induced acute pancreatitis is not different from acute pancreatitis associated with other causes."

Different Clinical Presentations of Hyperlipidemic Acute Pancreatitis

“…Different outcomes have also been reported in previous studies. It was reported that there was no difference in mortality between patients with HLAP and those with NHLAP by Navarro et al 16 It was suggested by Jiang et al 18 and Kostapanos et al 19 that the clinical manifestation and prognosis of HLAP are not different from those of NHLAP. But a higher mortality was reported in patients with HLAP by Deng et al, 20 and Baranyai et al 21 found that severe prognosis and local complications were more frequent in HLAP compared with NHLAP.…”

Estrogen-Induced Pancreatitis: Transgender Females at Risk

“…Secondary factors contributing to hypertriglyceridemia should be evaluated and treated as their prevention may reduce the risk for acute pancreatitis. Alcohol use should be decreased, tight glycemic control should be established, hypothyroidism should be treated, and lipid-lowering therapy with fibrates should be initiated (6,7,16). A multidisciplinary team is essential to treatment success in the transgender population and should include professionals familiar with both gender dysphoria and transgender hormone therapy.…”

“…Estrogen therapy, whether as oral contraception or hormone replacement therapy in post-menopausal women, is a rare, yet well-documented, cause of acute pancreatitis with as many as 40 known reported cases. The presumed mechanism is estrogen-induced hypertriglyceridemia as most reported cases document triglyceride levels greater than 1,000 mg/dL (6). Levels of this magnitude are most commonly caused by primary or genetic defects in lipid metabolism.…”

“…The mechanism of estrogen-induced hypertriglyceridemia has been studied and is established (9). The risk of hypertriglyceridemia-induced acute pancreatitis is relevant with triglyceride levels greater than 500 mg/dL (6). Various authors even suggest that exogenous estrogens are relatively contraindicated when serum triglycerides are more than 300 mg/dL and absolutely contraindicated if triglyceride levels are more than 500 mg/dL (6,7,9).…”

“…The risk of hypertriglyceridemia-induced acute pancreatitis is relevant with triglyceride levels greater than 500 mg/dL (6). Various authors even suggest that exogenous estrogens are relatively contraindicated when serum triglycerides are more than 300 mg/dL and absolutely contraindicated if triglyceride levels are more than 500 mg/dL (6,7,9). Current estrogen therapy options for the transgender population include oral estradiol, transdermal estradiol patch, and parenteral estradiol valerate or cypionate (10).…”