Emergent triglyceride-lowering therapy for hypertriglyceridemic pancreatitis.

Abstract

Background/aims: Hypertriglyceridemia (HTG) is recognized as a main cause of acute pancreatitis. The clinical course of hypertriglyceridemic pancreatitis (HTGP) is usually severe and often associated with complications. Patients with HTGP need therapeutic strategies aimed at rapidly reducing triglyceride (TG) serum levels. Here we review the effects of Emergent triglyceride-lowering therapies as well as their ad vantages and controversies.

Methodology: PubMed and MEDLINE were searched for articles using the keywords hypertriglyceridemia", "hyperlipidemia and "pancreatitis until September 2012.

Results: In sulin is a non-invasive, economic and safe treatment but the efficiency of insulin is still limited. Combined use of insulin and heparin, especially low molecular weight heparin (LMWH), remains an acceptable therapeutic option in early stages of HTGP. Therapeutic plasma exchange (TPE) and double-filtration (DF) provides a direct option for the removal of pathogenic substances. However, both of these therapies are expensive and not widely available, and TPE has risks for infection and allergic reactions. Medium chain triglycerides, omega-3-fatty acids, fibrates, niacin, microsomal transport protein inhibitors and gene therapy may be potential adjuvant therapies for achieving per- manent control of HTGP.

Conclusions: Insulin, LMWH combined with insulin, TPE and DF could be used as emergent therapies for HTCP.