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. 2020 Mar;49(3):429-434.
doi: 10.1097/MPA.0000000000001505.

Hypertriglyceridemia Induced Pancreatitis: Inpatient Management at a Single Pediatric Institution

Holly M Ippisch  1 , Ligia Alfaro-Cruz  2 , Lin Fei  3 , Yuanshu Zou  4 , Tyler Thompson  5 , Maisam Abu-El-Haija  5
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Hypertriglyceridemia Induced Pancreatitis: Inpatient Management at a Single Pediatric Institution

Holly M Ippisch et al. Pancreas. 2020 Mar.

Abstract

Objectives: Hypertriglyceridemia-induced pancreatitis is an important cause of acute pancreatitis (AP) in children, which lacks established guidelines. The aim of this study was to review management approaches at a single pediatric center.

Methods: This retrospective study included all inpatients younger than 21 years with AP and triglycerides (TG) of 1000 mg/dL or greater. A linear mixed effect model was used to calculate drop in TGs. The patient's diet, intravenous fluid (IVF) rate, insulin, and plasmapheresis were included in the model.

Results: Seventeen admissions were identified among 8 patients, average age 15 years (range, 6-19 years). Fifty percent had recurrent AP and 29% of admissions had complications including 1 death. The population was primarily female (75%), white (75%), and overweight, and 63% had diabetes. The median stay was 5.4 days. There were 14 approaches used with variations in IVF rates, insulin, plasmapheresis, and nill per os (NPO) versus feeds. Variables that reduced TG's were NPO, higher IVF rates, plasmapheresis, and insulin (P < 0.05). Importantly, NPO reduced TGs faster than those who started early nutrition.

Conclusions: Hypertriglyceridemia is an important cause of pancreatitis in children. This study shares a management algorithm from a single institution. Larger studies are needed for more evidence-based guidelines.

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References

    1. Pinhas-Hamiel O, Chernausek SD, Zeitler P. Acute necrotizing pancreatitis in an adolescent with type 2 diabetes. Curr Opin Pediatr. 2006;18:206–208.
    1. Stewart WA, Gordon K, Camfield P. Acute pancreatitis causing death in a child on the ketogenic diet. J Child Neurol. 2001;16:682.
    1. Wolfgram PM, Macdonald MJ. Severe hypertriglyceridemia causing acute pancreatitis in a child with new onset type I diabetes mellitus presenting in ketoacidosis. J Pediatr Intensive Care. 2013;2:77–80.
    1. Bălănescu NR, Topor L, Ulici A, et al. Acute pancreatitis secondary to hyperlipidemia in an 11-year-old girl: a case report and review of literature. J Med Life. 2013;6:2–6.
    1. Blackett P, Tryggestad J, Krishnan S, et al. Lipoprotein abnormalities in compound heterozygous lipoprotein lipase deficiency after treatment with a low-fat diet and orlistat. J Clin Lipidol. 2013;7:132–139.

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