Systematic review of hypertriglyceridemia-induced acute pancreatitis: A more virulent etiology?

Pancreatology. Jul-Aug 2016;16(4):469-76. doi: 10.1016/j.pan.2016.02.011. Epub 2016 Mar 3.

Abstract

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.

Keywords: Acute pancreatitis; Etiology; Hypertriglyceridemia; Necrotizing pancreatitis; Plasmapheresis; Systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Hypertriglyceridemia / complications*
  • Hypertriglyceridemia / epidemiology
  • Hypertriglyceridemia / therapy
  • Pancreatitis / epidemiology
  • Pancreatitis / etiology*
  • Pancreatitis / therapy
  • Triglycerides / blood

Substances

  • Triglycerides