Systematic review of hypertriglyceridemia induced acute pancreatitis: A more virulent etiology?
OBJECTIVE We sought to define the severity and natural history of hypertriglyceridemia induced acute pancreatitis (HTG AP) specifically whether HTG AP causes more severe AP than that caused by other etiologies. METHODS Systematic review of the English literature. RESULTS Thirty four studies (15 countries; 1972 2015) included 1340 HTG AP patients (weighted mean prevalence of 9% The median admission triglyceride concentration was 2622 mg/dl (range 1160 9769) Patients with HTG have a 14% weighted mean prevalence of AP. Plasmapheresis decreased circulating triglycerides, but did not conclusively affect AP mortality. Only 7 reports (n 392 patients) compared severity of HTG AP to that of AP from other etiologies. Of these, 2 studies found no difference in severity, while 5 suggested that HTG AP patients may have increased severity compared to AP of other etiology. CONCLUSIONS 1) hypertriglyceridemia is a relatively uncommon (9% cause of acute pancreatitis; however, patients with hypertriglyceridemia have a high (14% incidence of acute pancreatitis; 2) plasmapheresis may offer specific therapy unique to this patient population; and 3) data specifically comparing the severity of HTG AP with AP caused by other etiologies are heterogeneous and scarce.
Pancreatology official journal of the International Association of Pancreatology (IAP) [et al.