~5% of acute pancreatitis caused by high triglycerides
Etiologies
Familial<unk> , autosomal dominant with variable penetrance
Secondary forms
DM, obesity, EtOH, estrogen therapy
Hypothyroidism, ESRD, nephrotic syndrome, HIV, anti-HIV meds
TG levels > 2000mg/dL almost always have both secondary and genetic form
1.7% of US estimated to have [TG] between 500-2000
May present with normal serum lipase levels
Familial<unk> , autosomal dominant with variable penetrance
Secondary forms
DM, obesity, EtOH, estrogen therapy
Hypothyroidism, ESRD, nephrotic syndrome, HIV, anti-HIV meds
DM, obesity, EtOH, estrogen therapy
Hypothyroidism, ESRD, nephrotic syndrome, HIV, anti-HIV meds
Excess TG hydrolyzed by increased concentration of pancreatic lipase
Produces increased concentration of free fatty acids that exceeds binding capacity of albumin
Micelles are formed that attack platelets, vascular endothelium and acinar cells
Ischemia and pancreatic injury result
An acidic environment potentiates free fatty acid toxicity
Hypertriglyceridemia
Gastroesophageal reflux disease 
Polycythemia
Peptic ulcer disease with or without perforation
Lactic acidosis
Gastritis
Ketonemia
Pancreatitis