Plasmapheresis as an Adjuvant Therapy for Hypertriglyceridemia-Induced Pancreatitis

Iskandar, Said B.; Olive, Kenneth E.

doi:10.1097/00000441-200411000-00010

Cited by 56 publications

(19 citation statements)

References 13 publications

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“…Acquired causes include uncontrolled diabetes mellitus, alcohol abuse, pregnancy, medications, hypothyroidism, nephrotic syndrome, and high carbohydrate diets [5, 6, 8, 9]. …”

Section: Discussionmentioning

confidence: 99%

“…While pancreatitis is usually diagnosed from typical clinical symptoms and raised pancreatic enzymes that are at least twice the upper normal limit [2], in hypertriglyceridemia, these enzymes may be spuriously normal or only mildly raised [3–5, 10]. These effects have been well documented for amylase, but there is limited data regarding lipase levels.…”

Section: Discussionmentioning

confidence: 99%

“…Amylase and lipase serum levels, both diagnostic markers for pancreatitis [2], may be spuriously normal or only mildly raised in the setting of hypertriglyceridemia [3–5], obscuring a diagnosis of pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

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Use of Plasmapheresis in Managing the Diagnostic Dilemma of Symptomatic Hypertriglyceridemia

Maher

Ramaswamykanive

2012

Case Reports in Gastrointestinal Medicine

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We present a case study of a 29-year-old male who presented with abdominal pain typical for pancreatitis. Detailed history and investigations revealed that the cause of abdominal pain was secondary to the raised triglyceride levels. It was difficult to distinguish whether he had hypertriglyceridemia-induced abdominal pain or acute pancreatitis, given that he had only a mildly raised lipase and a normal contrast computed tomography scan of the pancreas. The abdominal pain resolved with the fall in the triglyceride levels following plasmapheresis. Plasmapheresis is an underevaluated modality of the treatment of hypertriglyceridemia due to its cost and availability.

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“…Acquired causes include uncontrolled diabetes mellitus, alcohol abuse, pregnancy, medications, hypothyroidism, nephrotic syndrome, and high carbohydrate diets [5, 6, 8, 9]. …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Use of Plasmapheresis in Managing the Diagnostic Dilemma of Symptomatic Hypertriglyceridemia

Maher

Ramaswamykanive

2012

Case Reports in Gastrointestinal Medicine

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“…Plasmapheresis and extracorporeal lipid elimination are therapeutic alternatives. [38] Plasma exchange can dramatically reduce excessive lipid levels,[1819] as was seen in our two cases. Our second patient presented with triglyceridemia-induced pancreatitis in the 27 th week of pregnancy.…”

Section: Discussionmentioning

confidence: 63%

“…AP might be seen in cases with familial hypertriglyceridemia at pregnancy and cases resistant to medical therapy can be treated with plasmapheresis successfully. [89]…”

Section: Introductionmentioning

confidence: 99%

An alternative treatment in hypertriglyceridemia-induced acute pancreatitis in pregnancy: Plasmapheresis

Altun

Eren

Çukurova

et al. 2012

J Anaesthesiol Clin Pharmacol

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Hormonal influences during pregnancy can compromise otherwise controlled lipid levels in women with familial hypertriglyceridemia and predispose to pancreatitis leading to increased morbidity in both mother and fetus. Both cholesterol and triglyceride levels in serum increase progressively during pregnancy. The mainstay of treatment includes dietary restriction of fatty meal and lipid-lowering medications. Experiences with plasmapheresis are limited. We report two cases of hypertriglyceridemia-induced acute pancreatitis during pregnancy, which were successfully treated by plasmapheresis.

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Postpartum plasma exchange as adjunctive therapy for severe acute fatty liver of pregnancy

Martin

Briery

Rose

et al. 2008

J of Clinical Apheresis

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Acute fatty liver of pregnancy (AFLP) is a rare disease of progressive hepatic insufficiency and secondary systemic compromise that poses significant fetal-maternal risk. Plasma exchange (PEX) is an effective bridge therapy to sustain liver function and enable hepatocellular regeneration to occur in nonpregnant patients following acute decompensation of a chronic liver disease or while awaiting liver transplantation. The application of PEX for patients with AFLP is a novel concept; since 1988 we have utilized postpartum PEX (PPEX) as adjunctive medical therapy for six patients with severe AFLP. Before PPEX initiation, four patients had signs and symptoms of encephalopathy, three required ventilatory support, five had advanced liver insufficiency, and all six were developing renal failure. PPEX was initiated 2-8 days following delivery and repeated (two to four times, mean = 3) at 24-48-h intervals thereafter. All patients responded with composite clinical (symptoms/signs) and laboratory improvement; the average length of hospitalization following final PPEX for five of six patients was 7 days. No significant PPEX-related complications occurred. PPEX utilization in patients with severe AFLP may enhance maternal recovery by preventing secondary sequelae from hepatic insufficiency until spontaneous healing can occur. Further study appears to be indicated to validate a role for PPEX as supportive therapy for puerperal patients with AFLP suffering multiorgan failure.

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Plasmapheresis as an Adjuvant Therapy for Hypertriglyceridemia-Induced Pancreatitis

Cited by 56 publications

References 13 publications

Use of Plasmapheresis in Managing the Diagnostic Dilemma of Symptomatic Hypertriglyceridemia

Use of Plasmapheresis in Managing the Diagnostic Dilemma of Symptomatic Hypertriglyceridemia

An alternative treatment in hypertriglyceridemia-induced acute pancreatitis in pregnancy: Plasmapheresis

Postpartum plasma exchange as adjunctive therapy for severe acute fatty liver of pregnancy

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