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Therapeutic plasma exchange for hypertriglyceridemia induced acut pancreatitis: the 33 cases experience from a

Altay Kandemir1, Adil Coşkun1, İrfan Yavaşoğlu2

  • 1Department of Gastroenterology, Adnan Menderes University School of Medicine, Aydın, Turkey.

The Turkish Journal of Gastroenterology : the Official Journal of Turkish Society of Gastroenterology
|October 6, 2018
PubMed

Insights

Therapeutic plasma exchange (TPE) effectively lowers triglyceride levels in patients with hypertriglyceridemia-induced acute pancreatitis (HTG-AP). TPE is a safe treatment, especially for severe cases, with low complication rates and reduced mortality.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Critical Care Medicine

Background:

  • Hypertriglyceridemia (HTG) is a significant cause of acute pancreatitis.
  • Severe HTG (>1000 mg/dL) necessitates prompt reduction of triglycerides and chylomicrons.
  • Hypertriglyceridemia-induced acute pancreatitis (HTG-AP) presents a clinical challenge requiring effective management strategies.

Purpose of the Study:

  • To evaluate the efficacy and safety of therapeutic plasma exchange (TPE) in patients with HTG-AP.
  • To assess the impact of TPE on triglyceride and cholesterol levels.
  • To analyze patient outcomes, including pancreatitis severity, complications, and mortality.

Main Methods:

  • Retrospective case series of 33 patients with HTG-AP treated with TPE.
  • Data collection included clinical outcomes and triglyceride level reduction.
  • Patients were categorized based on the revised Atlanta criteria for pancreatitis severity.

Main Results:

  • A single TPE session reduced triglyceride levels by 54.4% and total cholesterol by 52.1%.
  • Two TPE sessions achieved a 79.4% triglyceride reduction.
  • Overall mortality was 3%, with a 33.3% mortality rate in severe HTG-AP cases. No significant TPE-related complications were observed.

Conclusions:

  • Therapeutic plasma exchange (TPE) is a safe and effective treatment for HTG-AP.
  • TPE demonstrates significant efficacy in reducing triglyceride levels.
  • TPE should be considered, particularly for patients with severe HTG-AP, due to its safety profile and positive impact on outcomes.
Abstract

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