Epidemiology, clinical features, and management of hypertriglyceridemia-induced pancreatitis: A case series

Abstract

Background: Hypertriglyceridemia-induced pancreatitis accounts for up to 15 % of all acute pancreatitis admitted to hospitals. It is important to diagnose the etiology to provide adequate and timely management of the case and reduce complications. Epidemiological and clinical data on hypertriglyceridemia-induced pancreatitis in the Intensive Care Unit (ICU) are scarce, especially in Middle Eastern countries. We are reporting a case series of 18 patients admitted managed in the ICU over a period of 10 months. Methods: All patients above 18 years of age were diagnosed with hypertriglyceridemia-induced pancreatitis admitted to the ICU and High Dependency Unit (HDU), were included. Our objectives were to characterize the clinical and epidemiological features of hypertriglyceridemia-induced pancreatitis (HTG-AP) and calculate the number of insulin infusion days required to manage HIP. Results: Patients were mostly middle-aged males from different ethnicity. Most of the patients presented with abdominal pain elevated pancreatic enzymes, and triglyceride. The mean triglyceride level on admission was 15.68 mmol/L. Most clinical findings were resolved when the triglyceride level dropped to below 5.6 mmol/L within 3.5 days. All patients presented with mild forms of pancreatitis without major complications. Fifty percent of our patients showed radiological features of acute pancreatitis, but no one developed local complications. Conclusion: Our case series showed that hypertriglyceridemia is a common cause of acute pancreatitis in Qatar. Upon admission, the mean triglyceride level was 15.68 mmol/L and the cause of the hypertriglyceridemia was unclear but could be related to ethnicity. Patients were primarily managed with insulin therapy and supportive care. None of the patients developed any local complications such as necrotizing pancreatitis or abscess formation. Around 16% of the patients had systemic complications, which were managed successfully.