scholarly journals Heparin and Insulin for Hypertriglyceridemia-Induced Pancreatitis: Case Report

2009 ◽  
Vol 9 ◽  
pp. 1230-1232 ◽  
Author(s):  
Deepika Jain ◽  
John Zimmerschied
Keyword(s):  
Fatty Acids ◽  
Acute Pancreatitis ◽  
Case Report ◽  
Serum Triglyceride ◽  
Serum Triglyceride Level ◽  
Supportive Treatment ◽  
Lipoprotein Lipase Activity ◽  
Heparin Infusion ◽  
Intravenous Insulin ◽  
Time Of Admission

Hypertriglyceridemia is the etiology of acute nonbiliary pancreatitis in up to 3% of patients. Along with the supportive treatment of acute pancreatitis, treating the precipitating cause is important as well. There have been reports where heparin and insulin have been used for acute reduction of triglycerides, although there are no established guidelines for efficacy of these modalities. Heparin and insulin decrease triglycerides by stimulating lipoprotein lipase activity, which degrades triglycerides into fatty acids and glycerol. We present a case where a 54-year-old male presented with hypertriglyceridemia-induced acute pancreatitis. The serum triglyceride level was 10,320 mg/dl (normal: 0–15 mg/dl) at the time of admission. We started the patient on intravenous insulin and heparin infusion, and within 24 h of induction of treatment, the levels decreased by 50% to 5407 mg/dl. Thus, heparin and insulin can be considered a safe treatment modality for rapidly reducing triglyceride levels.

Hypertriglyceridemia induced by S-1: A novel case report and review of the literature

2020 ◽  
pp. 107815522095669
Author(s):  
Yoshitaka Saito ◽  
Yoh Takekuma ◽  
Yoshito Komatsu ◽  
Mitsuru Sugawara
Keyword(s):  
Case Report ◽  
Elevated Serum ◽  
Serum Triglyceride ◽  
Colon Adenocarcinoma ◽  
Stage Iv ◽  
Chemotherapeutic Agents ◽  
Serum Triglyceride Level ◽  
Withdrawal Period ◽  
Metabolizing Enzymes ◽  
Temporal Occurrence

Introduction S-1, a compounding agent of tegafur, gimeracil, and oteracil potassium, is one of the most effective chemotherapeutic agents for colorectal cancer. In this case, following S-1 administration, we observed predominant elevation of serum triglyceride. Case report A 49-year-old man with stage IV transverse colon adenocarcinoma received S-1 + irinotecan + bevacizumab. At the end of the S-1 administration period in every course, his serum triglyceride level was found to be elevated. Finally, it reached grade 4, without any symptoms of acute pancreatitis in the fifth course, and fenofibrate 80 mg once a day was administered. Management & outcome: Interestingly, the elevation spontaneously normalized without any pharmacotherapy 14 days after S-1 withdrawal, and this elevation did not occur when S-1 was not administered. Further, fenofibrate administration attenuated the hypertriglyceridemia to grades 1-3, with no complications. Discussion S-1 administration induced hypertriglyceridemia owing to the elevated serum triglyceride; however, a contrasting result was observed in the S-1 withdrawal period and during the S-1-cessation cycle. Since dietary intake was poorer during the S-1 administration period, it is considered that S-1 might have disturbed lipid metabolism. Further, we know that capecitabine, which is a prodrug of fluorouracil, also induces hypertriglyceridemia. As the end product of these medicines is fluorouracil, the presence of fluorouracil or its metabolizing enzymes, the genetic background of the patient might have affected the results. We have to be aware of the risk of asymptomatic and temporal occurrence of hypertriglyceridemia by S-1 administration for the early detection with appropriate pre-emptive treatment.

scholarly journals Hypertriglyceridemia: An indicator of poor prognosis in acute pancreatitis – A hospital based study

2014 ◽  
Vol 5 (4) ◽  
pp. 21-24
Author(s):  
Mosin Mushtaq ◽  
Abid H Wani ◽  
Faud Sadiq ◽  
Mudasir Mushtaq ◽  
Sameena Tabassum ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Serum Triglyceride ◽  
Final Conclusion ◽  
Medical Sciences ◽  
Gall Stones ◽  
Group A ◽  
Study Population ◽  
The Mean ◽  
Group B ◽  
Time Of Admission

Background and study aims: Hypertriglyceridemia can be a primary cause for acute pancreatitis or secondary to other factors prior to the increase of lipid levels, or both. The aim of our study was to assess the severity of acute pancreatitis with elevation in serum triglyceride levels and report the outcomes of our series. Patients and methods: One hundred twenty?six patients of acute pancreatitis were admitted within 72 hours of onset of symptoms, out of whom 26 patients were excluded during the course of study due to preexisting comorbidities. 100 patients in the study population were divided into group A having serum triglyceride levels ≥500 mg/dl (n = 30) and group B having <500 mg/dl (n = 70) at the time of admission. Results: The mean age of group A was similar to group B (50.2 ± 17.1 vs 49.26 ± 17.2 years; p = 0.860). Most common etiological factor of acute pancreatitis was found to be gall stones (56%) in both groups. Ranson's score at admission in group A was 2.93 ± 0.22 and in group B it was 1.34 ± 0.99. Mortality below two weeks was noted in (12/30, 40%) of group A and (6/70, 8%) of group B patients, which was statistically significant, (p = 0.015). Conclusions: The final conclusion of this study was that patients of acute pancreatitis with elevated triglyceride levels form a morbid group and these should be monitored aggressively for the development of any complications. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9971 Asian Journal of Medical Sciences 2014 Vol.5(4); 21-24

scholarly journals Hypertriglyceridemia with total parenteral nutrition versus enteral nutrition in patients with acute pancreatitis

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
B B Ghobreal ◽  
S F Mahmoud ◽  
H S A Elsamie ◽  
A M Metwally
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Serum Triglyceride ◽  
The Other ◽  
University Hospital ◽  
Serum Triglyceride Level ◽  
Serum Triglycerides ◽  
Local Injury

Abstract Background Acute pancreatitis (AP) is an inflammatory condition of the pancreas that can cause local injury, systemic inflammatory response syndrome, and organ failure. Worldwide, AP is a common gastrointestinal condition and there is evidence that the incidence has been rising in recent years. AP is associated with substantial suffering, morbidity, and cost to the health care system. Objective Our study aims to compare between the effect of enteral (EN) and parenteral nutrition on serum triglycerides in patient with acute pancreatitis in intensive care unit of Ain Shams University (ICU). We found that enteral route is more safe than parenteral nutrition regarding serum triglycerides. Patients and Methods An informed written consent was obtained from patients and /or relatives who were included in this study. All patients were adults, more than 18 years old, admitted to ICU of Ain Shams University Hospital, either have acute pancreatitis on admission or acquired acute pancreatitis in ICU due to different causes in period of six months of approval of the protocol. Patients were divided into two groups: 30 patients started total parenteral nutrition TPN ) one day after admission consisting of 70% carbohydrate (in the form of dextrose 25%) and 30% fat (smoflipid 250 ml, 2 gm per ml). The other 30 patients started enteral nutrition rich in carbohydrates with low fat content one day after admission (peptamen) 6 scoops in 200 ml water every 2 hours, stopped from 12 am to 8 am. Serum triglyceride level was measured at first day of admission, then 3 days after admission, then one week after admission. Results Our study showed that TPN was associated with more increase of serum triglycerides level from first day of admission to 3 days after admission when compared with enteral nutrition, there is also increase in serum triglycerides from 3days to one week after admission, comparing the three periods together, there is increase in serum triglycerides with TPN group more than in enteral group. Conclusion The study showed that TPN was associated with higher mortality rate than EN, also there was an increase in serum triglycerides with TPN more than EN; suggesting that, enteral nutrition is a safer mode of nutrition in patients with acute pancreatitis.

scholarly journals Severe L-asparaginase-induced Hypertriglyceridaemia Treated with Plasmapheresis

2021 ◽  
Author(s):  
José Silvano ◽  
Nídia Marques ◽  
Isabel Tavares ◽  
Inês Ferreira
Keyword(s):  
Acute Pancreatitis ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Platelet Transfusion ◽  
Insulin Infusion ◽  
Drug Withdrawal ◽  
Removal Rate ◽  
Serum Triglyceride ◽  
Intravenous Insulin ◽  
Fatal Complications

L-asparaginase is used for the treatment of acute lymphoblastic leukaemia. Hypertriglyceridaemia is a side effect and associated with potentially fatal complications, including acute pancreatitis. Plasmapheresis may have a role in treatment when triglycerides are >2000 mg/dl. We report the case of a 39-year-old woman treated with L-asparaginase for acute lymphoblastic leukaemia, who developed severe hypertriglyceridaemia (6560 mg/dl) and acute pancreatitis. Intravenous insulin infusion was started, along with fenofibrate and atorvastatin administration, and platelet transfusion. Plasmapheresis was carried out leading to a frank decline in serum triglyceride levels (366 mg/dl), a decrease in pancreatic enzymes and clinical improvement. The diagnosis of pancreatitis secondary to L-asparaginase should lead to immediate drug withdrawal, and plasmapheresis should be considered when serum triglyceride values exceed 2000 mg/dl. In our case, there was a 95% triglyceride removal rate. This response illustrates the strong effectiveness of early treatment with plasmapheresis in severe and symptomatic hypertriglyceridaemia associated with L-asparaginase.

scholarly journals Serum Triglyceride Level: A Predictor of Complications and Outcomes in Acute Pancreatitis?

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Hassan Tariq ◽  
Vinaya Gaduputi ◽  
Richard Peralta ◽  
Naeem Abbas ◽  
Suresh Kumar Nayudu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Length Of Stay ◽  
Triglyceride Level ◽  
Independent Predictor ◽  
Serum Triglyceride ◽  
Hospital Length Of Stay ◽  
Serum Triglyceride Level ◽  
Systemic Complications

Aim.To study serum triglyceride level as a predictor of complications and outcomes in acute pancreatitis.Methods.In this retrospective observational study, 582 patients admitted with acute pancreatitis, who had serum triglyceride levels measured within the first 24 hours, were divided into two groups. The study group consisted of patients with a triglyceride level ≥2.26 mmol/L (group 2) and the control group consisted of triglyceride level of <2.26 mmol/L (group 1). We collected data for baseline demographics, laboratory values, incidence of complications (local and systemic), admission to the intensive care unit (ICU), ICU length of stay, length of total hospital stay, and death in the two groups.Results.A triglyceride level of ≥2.26 mmol/L was found to be an independent predictor of developing altered mental status (p: 0.004), pancreatic necrosis (p: 0.001), acute respiratory distress syndrome (p: 0001), systemic Inflammatory response syndrome (p: 0.001), acute kidney injury (p: 0.001), hospital length of stay (LOS) (p: 0.002), admission to intensive care unit (ICU) (p: 0.002), and ICU LOS (p: 0.003).Conclusion.A triglyceride level of ≥2.26 mmol/L on admission in acute pancreatitis is an independent predictor of developing local and systemic complications, hospital LOS, admission to ICU, and ICU LOS.

scholarly journals Hypertriglyceridemia Induced by Fluorouracil: A Novel Case Report

2021 ◽  
pp. 207-211
Author(s):  
Yoshitaka Saito ◽  
Yoh Takekuma ◽  
Satoshi Yuki ◽  
Yoshito Komatsu ◽  
Mitsuru Sugawara
Keyword(s):  
Case Report ◽  
Triglyceride Level ◽  
Therapeutic Process ◽  
Serum Triglyceride ◽  
Serum Triglyceride Level ◽  
Epidemiological Features ◽  
Cessation Treatment ◽  
Grade 3 ◽  
The One ◽  
Experienced Grade

We had previously reported on S-1-induced hypertriglyceridemia. Here, we report fluorouracil-induced hypertriglyceridemia in a patient with capecitabine-induced hypertriglyceridemia and the corresponding therapeutic process. A woman in her forties who had experienced grade 3 hypertriglyceridemia due to oxaliplatin + capecitabine was administered fluorouracil ± oxaliplatin + levofolinate calcium + panitumumab; however, grade 4 hypertriglyceridemia occurred after the thirteenth administration. Bezafibrate normalized the elevation. Chemotherapy cessation resulted in its decrease to normal, and bezafibrate was stopped. Nine months after cessation, treatment with fluorouracil + irinotecan + levofolinate calcium + ramucirumab was initiated. After four cycles of treatment, her serum triglyceride levels increased again to grade 3, and then, fenofibrate was administered, resulting in a significant decrease to grade 1–2. Serum triglyceride levels significantly reduced after cessation of the prior fluorouracil-containing regimen, although its elevation was observed again following the latter treatment. Therefore, fluorouracil-induced hypertriglyceridemia was strongly speculated in this case. We have speculated that the most probable cause of tegafur and capecitabine-induced hypertriglyceridemia is fluorouracil or its metabolic enzymes since their end product is fluorouracil in the previous report. Results from this patient suggest that our supposition was correct. Fibrates administration, cessation of the treatment, and monitoring of serum triglyceride level was effective in this case as well as previous reports. Fluorouracil-induced hypertriglyceridemia is associated with the one caused by tegafur and capecitabine and presents the possibility of severe complications. Elucidation of its exact mechanism and epidemiological features is needed for better understanding.

scholarly journals Elevated Serum Triglyceride Level as a Predictor of Local and Systemic Complications in Acute Pancreatitis

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S887-S888
Author(s):  
N.J. Hidalgo ◽  
E. Pando ◽  
P. Alberti ◽  
M.J. Gómez ◽  
R. Mata ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Triglyceride Level ◽  
Elevated Serum ◽  
Serum Triglyceride ◽  
Serum Triglyceride Level ◽  
Systemic Complications ◽  
Local And Systemic Complications

scholarly journals Serum triglyceride level as a predictor of local complications and severity in acute pancreatitis

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S519
Author(s):  
M. Adell Trape ◽  
J.N. Hidalgo ◽  
E. Pando ◽  
P. Alberti ◽  
L. Vidal ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Triglyceride Level ◽  
Serum Triglyceride ◽  
Serum Triglyceride Level ◽  
Local Complications
Sign in / Sign up

Export Citation Format

Share Document