Plasmapheresis for recurrent acute pancreatitis from hypertriglyceridemia

Acute pancreatitis is a known complication of severe hypertriglyceridemia. Therapeutic experience with plasmapheresis is less well reported but has been highly successful in life-threatening presentations. We describe a 38-year-old obese Hispanic woman with a previous history of acute pancreatitis from diabetic hypertriglyceridemia who presented to the emergency department with a 2-day history of worsening abdominal pain. Plasmapheresis was initiated with one calculated plasma volume exchange using 5% albumin replacement within 24 hours of admission. Following this treatment, the triglyceride level fell 74%. Another session was performed the following day. The final triglyceride level represented a 93% reduction. This case is novel in that the patient presented twice within the same year with hypertriglyceridemic pancreatitis and responded well to prompt plasmapheresis therapy.