Abstract
Usefulness of Plasma Exchange for Hypertriglyceridemia - Induced Severe Acute Pancreatitis: Report of Three Cases
Highlights
There are various causes of severe acute pancreatitis (SAP) such as alcohol, gallstone disease, hyperlipidemia and several drugs
SAP is a systemic inflammatory disease mediated by various inflammatory mediators such as cytokines released by local inflammation of the pancreas, and systemic inflammation can develop to multiple organ dysfunction syndrome despite recent advances in intensive care management
Since severe HTG (TG of >1000 mg/ dL) is considered a risk for pancreatitis [18], we carry out plasma exchange for HTG-induced SAP if TG level is more than 1000 mg/dL
Summary
There are various causes of severe acute pancreatitis (SAP) such as alcohol, gallstone disease, hyperlipidemia and several drugs. According to the Japanese criteria for severity assessment of acute pancreatitis [4], the patient was diagnosed as having SAP by the findings of blood analysis and CT imaging (prognostic factors: 4, CT grade: 3) (Figure 1). Plasma exchange was performed on the first ICU day because serum TG level was increased to 3125 mg/dL. The patient was diagnosed as having mild acute pancreatitis and was treated by intravenous fluid replacement and antibiotics He was transferred to the ICU because the severity score of AP fulfilled the criteria of severe AP (prognostic factors: 3, CT grade: 2) on the 2nd EC day (Figure 3). Since the patient’s condition improved and prognostic factors were decreased to zero, the patients was discharged from the ICU on the 6th ICU day and medical treatment was continued in the general ward
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