Low phospholipid-associated cholelithiasis syndrome: A rare cause of acute pancreatitis that should not be neglected

Table 1 Patients’ characteristics at diagnosis

General characteristics
Median age (yr)	37 ± 11.8	(26–67)	n = 24
Gender: Male	14	(58)	n = 24
Median BMI (kg/m2)	24 ± 4.5	(18.9–34)	n = 24
Pregnancy at diagnosis	0	(0)	n = 10
Ethnicity			n = 24
Caucasian	12	(50)
Maghrebian	10	(42)
Asian	1	(4)
Sub-Saharan African	1	(4)
Medical history
Acute pancreatitis	13	(54)	n = 24
Cholecystectomy	10	(42)	n = 24
Family history of cholelithiasis in first-degree relatives	7	(30)	n = 23
Acute cholecystitis	3	(13)	n = 24
Acute cholangitis	3	(13)	n = 24
Chronic pancreatitis	0	(0)	n = 24
Cholestasis of pregnancy	0	(0)	n = 10
Estrogen therapy	0	(0)	n = 10
Existing medical conditions
Recurring pain	21	(88)	n = 24
Acute pancreatitis	9	(38)	n = 24
Acute cholecystitis	2	(14)	n = 14
Acute cholangitis	1	(4)	n = 24
Cytolysis			n = 23
Presence	13	(57)
Quantification (N)	2.8 ± 3.1	(0–10)
Cholestasis			n = 23
Presence	13	(57)
Quantification (N)	1.7 ± 2.0	(0–8)

Quantitative results: means ± SD. Qualitative results: n (%); BMI: Body mass index; N: Normal value.

Table 2 Radiological features unveiled during ultrasound examinations

Intrahepatic bile duct findings			n = 24
Comet-tail artifacts	23	(96)
Microlithiasis	20	(83)
Acoustic shadows	17	(71)
Stones	3	(13)
Associated findings
Gallstones	6	(43)	n = 14
Gallbladder sludge	2	(14)	n = 14
Gallbladder hydrops	1	(7)	n = 14
Common bile duct stones	1	(4)	n = 23

Qualitative results: n (%). Quantitative results: means ± SD.

Table 3 Patients’ characteristics during follow-up

Follow-up time (mo)	19.7 ± 5.8	(10.1–29.4)	n = 24
Patients’ care
Hospitalization
In a conventional care unit
Yes	18	(75)	n = 24
Duration (days)	6.8 ± 3.1	(2–14)	n = 18
In an intensive care unit	0	(0)	n = 24
Treatment
UDCA	18	(75)	n = 24
Cholecystectomy	5	(36)	n = 14
Outcome
Good adherence to UDCA	12	(67)	n = 18
UDCA efficacy	17	(94)	n = 18
Onset of action (in weeks)	3.4 ± 2.5	(2–12)	n = 17
Pain recurrence	5	(28)	n = 18
UDCA intolerance	2	(11)	n = 18
Death	0	(0)	n = 24

Qualitative results: n (%). Quantitative results: means ± SD. UDCA: Ursodeoxycholic acid.