Hypertriglyceridemia–induced acute pancreatitis: A systematic review of the literature

• Main Authors: Ionut Negoi, Sorin Paun, Massimo Sartelli, Fausto Catena, Luca Ansaloni, Ruxandra Irina Negoi, Mircea Beuran
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Journal of Acute Disease
• Subjects: Hypertriglyceridemia-induced; Acute pancreatitis; Systematic review; Etiology
• Online Access: http://www.jadweb.org/article.asp?issn=2221-6189;year=2017;volume=6;issue=1;spage=1;epage=5;aulast=Negoi

Objective: To summarize the current evidence about the hypertriglyceridemia–induced acute pancreatitis (HAP). Methods: Systematic review of the English language literature was conducted using PubMed/ Medline database from its inception until August 2016. As a searching methodology, we have used a combination of ‘acute pancreatitis’ and ‘hypertriglyceridemia’ as keywords into the title. >Results: The diagnosis of HAP should be based on two out of the three criteria recommended by the international guidelines: characteristic clinical picture, serum pancreatic enzymes, and appropriate imagistics. The diagnosis of HAP should be distinguished between mild hypertriglyceridemia (> 150 mg/dL), which accompanies around one-third of all-causes acute pancreatitis, and severe hypertriglyceridemia (> 1 000 mg/dL) which generates acute pancreatitis. There is mixed evidence regarding a worse prognosis for patients with HAP, and a clear conclusion cannot be drawn. Similar to all the other etiologies, in HAP the initial treatment efforts should be nonspecific and addressed to acute pancreatitis, while pharmacologic and mechanical techniques should be added to lower the serum triglycerides as soon as possible. >Conclusions: We may conclude that HAP should be managed to respect all the general principles, also adding all the available resources to lower the serum triglycerides value, as early as possible in the acute setting and on long-term to prevent recurrences.