Therapeutic Plasmapheresis: A Treatment Modality in Severe Hypertriglyceridemia in Adolescence

Severe hypertriglyceridemia (SHTG) is defined as plasma triglycerides >1000 mg/dl. It is a rare and understudied condition in children and adolescents. SHTG in pediatric patients may occur as a result of certain genetic disorders of enzymes involved in triglyceride synthesis and metabolism, or it may be seen secondary to uncontrolled diabetes, obesity, metabolic syndrome, or certain medications. SHTG can cause recurrent abdominal pain and acute pancreatitis. Rapid lowering of triglycerides is needed in SHTG to prevent these complications. However, there are no specific guidelines for the treatment of severe hypertriglyceridemia in children and adolescents. Here we report a case of a 16-year-old boy, who was diagnosed with metabolic syndrome three years back. He had a family history of diabetes type 2 and dyslipidemia. In the current case presentation, the patient presented with SHTG-induced acute pancreatitis, who was successfully treated using plasmapheresis. To our knowledge, no such case has ever been reported in Pakistan. Our case findings highlight the use of a less conventional method for the treatment of hypertriglyceridemia in children.