Systematic review of hypertriglyceridemia-induced acute pancreatitis: A more virulent etiology?
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.
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Hypertriglyceridemia is a relatively uncommon (9%) cause of acute pancreatitis.
“Hypertriglyceridemia is a relatively uncommon (9%) cause of acute pancreatitis.”
From 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia (2021) · cites this paper as [111]
Patients with severe hypertriglyceridemia have a relatively high incidence (14%) of acute pancreatitis.
“However, patients with severe hypertriglyceridemia have a relatively high incidence (14%) of acute pancreatitis (111).”
From 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia (2021) · cites this paper as [111]
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“Hypertriglyceridemia is generally defined as having a fasting serum triglyceride measurement that is increased above the 95th percentile for age and sex [25].”
BackgroundNawaz, H., Koutroumpakis, E., Easler, J., Slivka, A., Whitcomb, D. C., Singh, V. P., Yadav, D., & Papachristou, G. I. (2015) · American Journal of Gastroenterology · doi:10.1038/ajg.2015.261 · Cited by 296 · see citing works
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Virani, S. S., Morris, P. B., Agarwala, A., Ballantyne, C. M., Birtcher, K. K., Kris-Etherton, P. M., Ladden-Stirling, A. B., Miller, M., Orringer, C. E., & Stone, N. J. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.06.011 · Cited by 341 · see citing works
Hypertriglyceridemia and acute pancreatitis
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Conservative management in hypertriglyceridemia-associated pancreatitis
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- Authors
- Carr, R. A., Rejowski, B. J., Cote, G. A., Pitt, H. A., & Zyromski, N. J.
- Affiliations
- Indiana University School of Medicine (US)
- Indiana University Indianapolis (US)
- Corresponding author
- Zyromski, Nicholas J.
- Venue
- Pancreatology
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 16
- Issue
- 4
- Pages
- 469-476
- ISSN
- 1424-3903 (ISSN-L)
- OpenAlex
- W2289330998
- Cited by
- 247
- References
- 7
- Citations by year
- 2026: 15 · 2025: 31 · 2024: 35 · 2023: 32 · 2022: 36 · 2021: 23 · 2020: 30 · 2019: 19 · 2018: 14 · 2017: 9 · 2016: 3
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pancreatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gallbladder and Bile Duct Disorders
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Keywords
- hypertriglyceridemia-induced pancreatitis, hypertriglyceridemia, plasmapheresis, triglyceride levels, pancreatitis severity, natural history (disease), mortality
- MeSH terms
- Humans, Pancreatitis, Triglycerides, Hypertriglyceridemia
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