Plasmapheresis as an Early Treatment for Severe Hypertriglyceridemia, Acute Pancreatitis, and Diabetic Ketoacidosis

Abstract

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Therapeutic Plasmapheresis: A Treatment Modality in Severe Hypertriglyceridemia in Adolescence

“…To our knowledge, no pediatric case with a triad of DKA, SHTG, and AP has been reported in Pakistan. However, a few internationally reported cases have shown promising results in children with IV hydration and insulin therapy [9][10]. In our patient, the sudden worsening of symptoms and risks of various life-threatening complications of SHTG (i.e., pancreatic necrosis, stroke, and ischemia) led to the initiation of plasmapheresis.…”

Relação entre pancreatite aguda e emergências diabéticas: uma revisão de literatura

“…Posteriormente, havendo quadro de melhora, ocorre substituição para insulina subcutânea. Nos casos que envolveram HTG, com níveis de triglicérides séricos maiores que 1000 mg/dL, o tratamento com o uso de plasmaférese foi eficaz, após constatar que não há melhoras pelo tratamento tradicional insulínico (Chaudhry et al, 2021;Kravetz et al, 2021).…”

Plasmapheresis vs Conventional Insulin Therapy in Hypertriglyceridemia-Induced Acute Pancreatitis

“…Diverse studies on the use of insulin therapy in HTG-induced AP have yielded inconsistent results, with some studies targeting euglycemia instead of triglyceride (TG) levels, uncertain dose and route of administration, and triglyceride lowering rates [ 5 ]. A previous case report showed persistently elevated TG levels (>2000 mg/dl) after 20 hours of insulin therapy and plasmapheresis (PEX) was initiated by our nephrologist with a rapid response after the first therapy to a level of 451 mg/dl, and 69 mg/dl following the second section [ 8 ]. PEX has been shown to rapidly remove TGs from circulation, preventing further pancreatic cellular injury.…”