Saleh MA, Mansoor E, Cooper GS. Case of familial hyperlipoproteinemia type III hypertriglyceridemia induced acute pancreatitis: Role for outpatient apheresis maintenance therapy. World J Gastroenterol 2017; 23(40): 7332-7336 [PMID: 29142480 DOI: 10.3748/wjg.v23.i40.7332]
Corresponding Author of This Article
Gregory S Cooper, MD, Division of Gastroenterology and Liver Disease, Department of Internal Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, United States. gregory.cooper@uhhospitals.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 28, 2017; 23(40): 7332-7336 Published online Oct 28, 2017. doi: 10.3748/wjg.v23.i40.7332
Case of familial hyperlipoproteinemia type III hypertriglyceridemia induced acute pancreatitis: Role for outpatient apheresis maintenance therapy
Mohannad Abou Saleh, Emad Mansoor, Gregory S Cooper
Mohannad Abou Saleh, Emad Mansoor, Department of Internal Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, United States
Gregory S Cooper, Division of Gastroenterology and Liver Disease, Department of Internal Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, United States
Author contributions: Abou Saleh M, Mansoor E and Cooper GS have all designed the case report, analyzed data, and written the manuscript.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at Case Western Reserve University/University Hospitals Cleveland Medical Center.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: There are no potential conflicts (financial, professional, or personal) to disclose by all the authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gregory S Cooper, MD, Division of Gastroenterology and Liver Disease, Department of Internal Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, United States. gregory.cooper@uhhospitals.org
Telephone: +1-216-8445385 Fax: +1-216-8445385
Received: May 30, 2017 Peer-review started: June 3, 2017 First decision: June 22, 2017 Revised: July 10, 2017 Accepted: August 1, 2017 Article in press: August 2, 2017 Published online: October 28, 2017 Processing time: 151 Days and 14.3 Hours
Abstract
Hypertriglyceridemic pancreatitis (HTGP) accounts for up to 10% of acute pancreatitis presentations in non-pregnant individuals and is the third most common cause of acute pancreatitis after alcohol and gallstones. There are a number of retrospective studies and case reports that have suggested a role for apheresis and insulin infusion in the acute inpatient setting. We report a case of HTGP in a male with hyperlipoproteinemia type III who was treated successfully with insulin and apheresis on the initial inpatient presentation followed by bi-monthly outpatient maintenance apheresis sessions for the prevention of recurrent HTGP. We also reviewed the literature for the different inpatient and outpatient management modalities of HTGP. Given that there are no guidelines or randomized clinical trials that evaluate the outpatient management of HTGP, this case report may provide insight into a possible role for outpatient apheresis maintenance therapy.
Core tip: There are a number of retrospective studies that have suggested a role for apheresis and insulin infusion in the acute management of hypertriglyceridemic pancreatitis (HTGP) but the post-discharge course and outpatient management of HTGP remain unclear. We report a case of HTGP in a male with hyperlipoproteinemia type III who was treated successfully with insulin and apheresis on the initial inpatient presentation followed by bi-monthly outpatient maintenance apheresis sessions for the prevention of recurrent HTGP. We also reviewed the literature for the different inpatient and outpatient management modalities of HTGP.
