A case of severe hypertriglyceridemia-induced acute pancreatitis

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  • Yoshida Megumi
    Depatment of Anesthesiology, Yokohama City University Medical Center
  • Kuwahara Yuka
    Department of Intensive Care Medicine, Yokohama Rosai Hospital
  • Kimura Yasuhiro
    Department of Intensive Care Medicine, Yokohama Rosai Hospital
  • Nanao Taikan
    Department of Intensive Care Medicine, Yokohama Rosai Hospital
  • Sugawara You
    Department of Intensive Care Medicine, Yokohama Rosai Hospital
  • Nishizawa Hideo
    Department of Intensive Care Medicine, Yokohama Rosai Hospital

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  • 著明な高トリグリセリド血症による重症急性膵炎の一例

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A 42-year-old woman was admitted to the hospital with a complaint of abdominal pain, nausea and vomiting. She was diagnosed with severe acute pancreatitis based on the laboratory results and the enhanced CT of the abdomen. She was transferred to the ICU due to the aggravation of prognostic factor from 1 to 5 during the first 3 days of admission. Due to the extremely high serum triglyceride (TG) level (12,815 mg/dl) at the time of admission, her acute pancreatitis seemed to be caused by her severe hypertriglyceridemia. Plasma exchange was not performed because TG level was already decreased to 1,990 mg/dl when she arrived in the ICU. Continuous i.v. of both insulin and heparin were administered to further decrease the TG level. In the ICU, the TG level was decreased rapidly, and the supportive therapy such as fluid therapy and enteral feeding helped her recover from the acute pancreatitis. She was discharged from ICU on the day 14. The patient in this study had extremely high level of TG caused by various factors including diabetes, obesity, and drugs.

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