PANCREATITIS AGUDA SECUNDARIA A HIPERTRIGLICERIDEMIA: UNAENTIDAD A TENER EN CUENTA
Palabras clave:
nota clínica, hipertrigliceridemia, pancreatitis aguda, plasmaféresisResumen
La hipertrigliceridemia severa suele ser consecuencia de la combinación de una predisposición genética y la influencia de factores exógenos. Cifras de triglicéridos en sangre por encima de 1000 mg/dl se han asociado a mayor riesgo de pancreatitis aguda. La hipertrigliceridemia puede ser causa de pancreatitis aguda recurrente si ésta no es corregida. En casos seleccionados existen medidas específicas encaminadas a disminuir los valores de triglicéridos, como la insulina o la plasmaféresis.
Referencias
1. Murphy MJ, Sheng X, MacDonald TM, Wei L. Hypertriglyceridemia and acute pancreatitis. JAMA Intern Med 2013;173:162.
2. Scherer J, Singh VP, Pitchumoni CS, Yadav D. Issues in hypertriglyceridemic pancreatitis: an update. J Clin Gastroenterol. 2014;48(3):195-203. doi:10.1097/01.mcg.0000436438.60145.5a
3. Rashid N, Sharma PP, Scott RD, Lin KJ, Toth PP. Severe hypertriglyceridemia and factors associated with acute pancreatitis in an integrated health care system. J Clin Lipidol. 2016;10(4):880-890. doi:10.1016/j.jacl.2016.02.019
4. Wan J, He W, Zhu Y, et al. Stratified analysis and clinical significance of elevated serum triglyceride levels in early acute pancreatitis: a retrospective study. Lipids Health Dis 2017;16:124.
5. Kitagawa S, Sawai K. Hypertriglyceridemia-Induced Acute Pancreatitis with Normal Pancreatic Enzymes. Am J Med. 2018 Jul;131(7): e299-e300. doi: 10.1016/j.amjmed.2018.02.013.
6. Vipperla K, Somerville C, Furlan A, et al. Clinical Profile and Natural Course in a Large Cohort of Patients With Hypertriglyceridemia and Pancreatitis. J Clin Gastroenterol. 2017;51(1):77-85. doi:10.1097/MCG.0000000000000579
7. Henderson SR, Maitland R, Mustafa OG, Miell J, Crook MA, Kottegoda SR. Severe hypertriglyceridaemia in Type 2 diabetes mellitus: beneficial effect of continuous insulin infusion. QJM. 2013;106(4):355-359. doi:10.1093/qjmed/hcs238
8. Kuchay MS, Farooqui KJ, Bano T, et al. Heparin and insulin in the management of hypertriglyceridemia-associated pancreatitis: case series and literature review. Arch Endocrinol Metabol 2017;61:198.
9. Click B, Ketchum AM, Turner R, et al. The role of apheresis in hypertriglyceridemia-induced acute pancreatitis: A systematic review. Pancreatology 2015;15:313.
10. Rosenson RS. Fenofibrate: treatment of hyperlipidemia and beyond. Expert Rev Cardiovasc Ther 2008;6:1319.
