Therapeutic approaches in hypertriglyceridemia-induced acute pancreatitis: A literature review of available therapies and case series

J Clin Apher. 2020 Apr;35(2):131-137. doi: 10.1002/jca.21763. Epub 2019 Nov 14.


Hypertriglyceridemia-induced acute pancreatitis (HGAP) is the third most common etiology of acute pancreatitis. HGAP can be attributed to genetic disturbances in triglyceride metabolism or multiple secondary causes. Here, we presented three cases for HGAP and explored different therapeutic approaches for treating HGAP. A case series of three patients who presented with HGAP and underwent different therapeutic approaches was conducted. The first patient was a 37-year-old male who presented with nonsevere HGAP; he was treated with conservative therapy with insulin and heparin infusion, which resulted in clinical and laboratory improvement. The second patient was a 64-year-old male with human immunodeficiency virus on multiple highly active antiretroviral therapy. He presented with severe HGAP and multiorgan failure. After initiation of therapeutic plasma exchange, his HGAP resolved. The third patient was a 28-year-old male who presented with recurrent episodes of HGAP; his conservative therapy failed and was eventually escalated to therapeutic plasma exchange (TPE). HGAP can be attributed to genetic disturbances of lipid or secondary etiologies. A nonsevere form of HGAP can be managed with conventional therapy including insulin and heparin; however, severe HGAP may require TPE.

Keywords: hypertriglyceridemia; pancreatitis; therapeutic plasma exchange.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Diabetes Complications / complications
  • Heparin / metabolism
  • Humans
  • Hyperlipidemias / drug therapy
  • Hypertriglyceridemia / complications
  • Hypertriglyceridemia / immunology*
  • Hypertriglyceridemia / therapy*
  • Insulin / metabolism
  • Lipids / chemistry
  • Male
  • Middle Aged
  • Obesity / complications
  • Pancreatitis / etiology*
  • Plasma Exchange / methods*
  • Plasmapheresis / adverse effects
  • Triglycerides / blood


  • Insulin
  • Lipids
  • Triglycerides
  • Heparin