ACUTE PANCREATITIS REVEALING MAJOR HYPERTRIGLYCERIDEMIA

Abstract

Objective: Severe hypertriglyceridemia is a common risk factor for acute pancreatitis and atherosclerotic vascular disease. Our aim was to report a rare case of acute pancreatitis due to major hypertriglyceridemia. Design and method: We report a case of acute pancreatitis revealing major hypertriglyceridemia. Results: A 53-year-old man, was hospitalized in May 2022 in endocrinology departement with abdominal pain, nausea,vomiting and alteration of general condition. History: high blood pressure, type 2 diabetes, alcohol consumption and family history of high blood pressure, type 2 diabetes, dyslipidemia. Clinical examination showed defense on palapation in epigastrium and right flank. Biochemical analyses were as follows: hypertriglyceridemia at 76.42 mmol/L associated with hypercholesterolemia at 17.58 mmol/L, LDL-C = 2.25 mmol/L, HDL-C = 2.12 mmol/L, hyperglycemia = 10.62 mmol/L, HBA1C = 8.1%, Lipasemia = 281 UI/L. Abdominal ultrasound did not show lithiasis, abdominal CT scan revealed pancreatitis. The diagnosis of acute pancreatitis due to major hypertriglyceridemia was made. The patient was treated by plasmapheresis and triglyceride level was reduced to 2.5 mmol/L. The lipidogram showed an isolated elevation of VLDL and defined hypertriglyceridemia as Familial hyperlipoproteinemia type 4. Conclusions: Familial hyperlipoproteinemia type 4 syndrome is an uncommon condition. Acute pancreatitis secondary to severe hypertriglyceridemia is a condition with a high risk of mortality which requires prompt clinical suspicion and treatment.