Lipapheresis in the management of hyperlipidemic pancreatitis: Our experience in a series of 7 patients

Abstract

Aim of the study : To evaluate the efficacy of lipapheresis
in the management of hyperlipidemic pancreatitis (HLP).
Methodology : Seven patients (pts), (6 males and 1 female)
with mean age 40.8 years (range: 26 - 64 years) were included.
The diagnosis of pancreatitis was based upon clinical
symptoms, serum and urine amylase levels and/or abdominal
Computed Tomography (C/T) findings. Diagnosis of
HLP was confirmed, as all pts had serum triglyceride (TG)
levels of more than 1000mg/dl. All pts underwent 1-3 sessions
of plasma treatment, by using double cascade filtration.
During each session of plasmapheresis, three liters of
plasma were exchanged. All pts were followed-up monthly
after their discharge, for 6 months.
Results : In 3/7 (43%) a significant reduction of serum TG
and pancreatic enzymes was noted, within a few hours from
lipapheresis. In the remaining pts, the same results were
noted after a second (2/7,28.5%) or third (2/7,28.5%) session
of the procedure. Also, an impressive improvement of
pts clinical signs was observed. All sessions were well tolerated.
During the follow-up period, none of the pts reported
any episodes of abdominal pain or vomiting, while their
serum TG levels were well below 1000mg/dl. Moreover, serum
and urine amylase were within normal limits over the
same period.
Conclusion : It seems that lipapheresis is a promising and
safe treatment in pts with HLP. However, more studies with
a larger patient group are needed for further evaluation of
its efficacy.
Key words : Pancreatitis, Hypertriglyceridemia, lipapheresis,
plasma exchange