Recurrent Hypertriglyceridemia-induced Pancreatitis in Pregnancy

Musa, Antoine Abu; Usta, Ihab M.; Rechdan, Johnny B.; Nassar, Anwar H.

doi:10.1097/01.mpa.0000202943.70708.2d

Cited by 35 publications

(16 citation statements)

References 9 publications

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“…These changes have been ascribed to the increased estrogen levels present [1, 4]. As in our patient, triglyceride levels greater than 2000 mg/dl have been reported [1, 3]. A recent PubMed search using key words pregnancy, hemorrhagic pancreatitis, and hyperlipidemia revealed only 3 published cases.…”

Section: Commentsupporting

confidence: 53%

“…Other disorders that are associated with pancreatitis during pregnancy include alcohol abuse, trauma, viral infections, and medications. Hyperlipidemia is responsible for only a small percentage of cases that occur during pregnancy [1, 3]. Pregnant women with pre-existing hyperlipidemia are at higher risk for pancreatitis due to plasma triglyceride levels that increase between 2 to 4 folds during pregnancy in addition to a 50% increase in serum cholesterol.…”

Section: Commentmentioning

confidence: 99%

“…Although heparin is an option to control triglyceride levels, women with acute pancreatitis are at risk for life threatening hemorrhage within the pancreas, and therefore heparin could conceivably worsen the ultimate outcome. Additionally lipid lowering medication or plasma exchange has also been described in the literature as alternative therapies [1, 3, 6]. …”

Section: Commentmentioning

confidence: 99%

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Severe Hyperlipidemia Induced Hemorrhagic Pancreatitis during Pregnancy

Koscica

Nwaubani

Nazir

et al. 2009

Obstetrics and Gynecology International

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Background. We report a case of familial hyperlipidemia in pregnancy that resulted in hemorrhagic pancreatitis. Case. A patient at 27-week gestation was admitted for recurrent pancreatitis secondary to severe hyperlipidemia. With conservative care, the patient improved but on the fourth day of admission she experienced a sudden onset of hypotension and was diagnosed with hemorrhagic pancreatitis. Conclusion. Pancreatitis caused by hyperlipidemia is an uncommon event during pregnancy. A familiarity with the severe complications associated with this potentially life-threatening condition is important.

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Section: Commentsupporting

confidence: 53%

Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

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Severe Hyperlipidemia Induced Hemorrhagic Pancreatitis during Pregnancy

Koscica

Nwaubani

Nazir

et al. 2009

Obstetrics and Gynecology International

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“…Plasma triglycerides increase 2–4-fold in pregnancy (34), principally in the third trimester (35), due to increased triglyceride-rich lipoprotein production and decreased lipoprotein lipase activity (36). In women with abnormal lipoprotein metabolism, this can lead to severe hypertriglyceridemia and chylomicronemic syndrome, precipitating pancreatitis (35).…”

Section: Discussionmentioning

confidence: 99%

Pancreatitis in Pregnancy

Eddy

Gideonsen

Song

et al. 2008

Obstetrics &Amp; Gynecology

210

112

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Objective To estimate the incidence, etiology and complications of pancreatitis in pregnancy and identify factors associated with adverse outcomes. Methods Chart review of all patients diagnosed with pancreatitis and pregnancy from 1992–2001 at 15 participating hospitals. Information was collected on presentation, management and outcome, along with the number of deliveries at each hospital. Results During the 10 years of the study, 101 cases of pancreatitis occurred among 305,101 deliveries, yielding an incidence of one in 3,021 (.03%). There were no maternal deaths; perinatal mortality was 3.6%. Eighty-nine women had acute pancreatitis and twelve women had chronic pancreatitis. The majority (66%) of cases of acute pancreatitis were biliary in origin, and they were associated with better outcomes than non-biliary etiologies. Cases of gallstone pancreatitis that received surgical or endoscopic intervention during pregnancy had lower rates of preterm delivery and recurrence than those that were conservatively managed, but this difference was not significant (p=0.2). Alcohol was responsible for 12.3% of acute pancreatitis and 58% of chronic pancreatitis and was associated with increased rates of recurrence and preterm delivery. A calcium level, triglycerides or both was not obtained in half of cases identified as idiopathic. Conclusion Pancreatitis is a rare event in pregnancy, occurring in approximately 3 in 10,000 pregnancies. While it is most often acute and related to gallstones, non-biliary causes should be sought, as they are associated with worse outcomes.

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“…[10] Plasma TG increase two-fold to four-fold in pregnancy, principally in the third trimester, because of increased TG-rich lipoprotein production and decreased lipoprotein lipase activity. [11] In women with abnormal lipoprotein metabolism, this can lead to severe hypertriglyceridemia, precipitating pancreatitis. [12] General and specific therapy is available to reduce TG levels during the acute phase of pancreatitis, which may improve the outcome.…”

Section: Discussionmentioning

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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Recurrent Hypertriglyceridemia-induced Pancreatitis in Pregnancy

Cited by 35 publications

References 9 publications

Severe Hyperlipidemia Induced Hemorrhagic Pancreatitis during Pregnancy

Severe Hyperlipidemia Induced Hemorrhagic Pancreatitis during Pregnancy

Pancreatitis in Pregnancy

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

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