Hypertriglyceridemia-Induced Acute Pancreatitis Associated with Ruxolitinib for Hemophagocytic Lymphohistiocytosis: A...

Ruxolitinib is a Janus kinase inhibitor that has been associated with lipid abnormalities, including a 15% incidence of hypertriglyceridemia. We describe a case of a 37-year-old man with refractory T-cell lymphoma treated with ruxolitinib for hemophagocytic lymphohistiocytosis (HLH). Following ruxolitinib use, the patient developed severe epigastric abdominal pain with elevated amylase, lipase, and triglycerides. This led to a suspicion of hypertriglyceridemia-induced pancreatitis requiring an insulin infusion. Unfortunately, the patient experienced multiorgan failure and expired. While ruxolitinib has been associated with hypertriglyceridemia, severe lipid abnormalities, as observed in this case, are rare. Furthermore, assessing the incidence of severe hypertriglyceridemia in the setting of HLH is challenging, given that the disease itself contributes to elevated triglyceride levels. This case highlights the need for a more vigilant approach in monitoring lipid parameters when using ruxolitinib for HLH treatment, especially among patients with concomitant risk factors.