Abstract
Background/aim High triglyceride (TG) levels are associated with increases in atherosclerotic cardiovascular disease (CVD), hepatic steatosis, and pancreatitis. Acute pancreatitis is a condition with high mortality. Therapeutic plasma exchange (TPE) in the treatment of hypertriglyceridemic pancreatitis (HTGP) is a rapid and effective treatment modality. In this study, the results of TPE were evaluated and the frequency of lipoprotein lipase (LPL) mutation in these patients was determined.Materials and methods TPE was performed in 31 patients with HTGP at the Adult Therapeutic Apheresis Center.Results A TG level under 500 mg/dL was achieved by applying apheresis at a median of 2 times (IQR 2–2, min 1, max 6) in the 31 cases. LPL mutation was detected in 8 (25.8%) of the 31 hypertriglyceridemia cases. When TG levels before and after TPE were evaluated, the mean TG level before TPE was significantly higher (3132 ± 1472 mg/dL) than the mean TG level afterwards (948 ± 465 mg/dL, P < 0.001). This result represented a decrease of 69.7% TG after TPE.Conclusion TPE is a safe, fast, and effective treatment modality in experienced centers.
Highlights
Hypertriglyceridemia (HTG) is a disorder of lipid metabolism that is caused by increased dietary intake, excessive synthesis in the liver, impaired metabolism, or a combination of these effects [1]
Materials and methods: Therapeutic plasma exchange (TPE) was performed in 31 patients with hypertriglyceridemic pancreatitis (HTGP) at the Adult Therapeutic Apheresis Center
A TG level under 500 mg/dL was achieved by applying apheresis at a median of 2 times (IQR 2–2, min 1, max 6) in the 31 cases
Summary
Hypertriglyceridemia (HTG) is a disorder of lipid metabolism that is caused by increased dietary intake, excessive synthesis in the liver, impaired metabolism, or a combination of these effects [1]. Following alcohol consumption and cholelithiasis, HTG is the third most common cause of acute pancreatitis. In HTG, TGs are destroyed by pancreatic lipases, which cause the release of free fatty acids and subsequent lipotoxicity, leading to chemical pancreatitis [4]. When TG levels are >1000 mg/ dL, the risk of acute pancreatitis is 5%; the risk is 10%–20% when TG levels are >2000 mg/dL [5,6]. Despite this fact, there are no standard predefined TG values for pancreatitis development
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