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Updated: Jun 9, 2026

Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
Selective whole blood lipoprotein apheresis to prevent pancreatitis in drug refractory hypertriglyceridemia
Anders Hovland1, Randolf Hardersen, Tom Eirik Mollnes
1Department of Internal Medicine, Nordland Hospital, Bodø, Norway. anders.w.hovland@gmail.com
Insights
Lipoprotein apheresis effectively reduced triglyceride levels and prevented recurrent acute pancreatitis in a patient with severe hypertriglyceridemia. This treatment shows promise for managing drug-refractory cases.
Area of Science:
- Cardiology
- Endocrinology
- Gastroenterology
Background:
- Severe hypertriglyceridemia is a significant risk factor for acute pancreatitis.
- Apheresis, particularly plasmapheresis, is an established treatment for drug-refractory hypertriglyceridemia.
Observation:
- A patient with Crohn's disease and type 2 diabetes experienced recurrent pancreatitis due to extreme hypertriglyceridemia.
- Lipoprotein apheresis was initiated for treatment.
Findings:
- Lipoprotein apheresis markedly reduced triglyceride and lipoprotein levels.
- The patient experienced no further episodes of pancreatitis after treatment initiation.
- The procedure demonstrated good biocompatibility, with minimal cytokine level changes.
Implications:
- Selective lipoprotein apheresis is a feasible treatment option for severe, drug-refractory hypertriglyceridemia.
- Further studies are warranted to validate this therapeutic approach.
Context:
Severe hypertriglyceridemia is a known cause of acute pancreatitis, and apheresis treatment, most commonly plasmapheresis, has been used to treat patients with drug refractory hypetriglyceridemia for more than 30 years.
Case Report:
We report a case in which a woman with Crohn's disease and type 2 diabetes mellitus developed recurrent episodes of acute pancreatitis due to extreme hypertriglyceridemia. After the initiation of lipoprotein apheresis from whole blood, a marked reduction of triglyceride and lipoprotein levels was observed. Some inflammatory parameters were increased even if most of the cytokines were not detectable, indicating good biocompatibility of the filter.
Conclusions:
Triglyceride levels were lowered after initiating selective lipoprotein apheresis. More importantly, the patient did not experience any relapses of pancreatitis after the treatment was started. Hence this treatment is feasible in drug refractory hypertiglyceridemia, but the treatment concept needs to be tested in additional studies.
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