Plasma Exchange for the Treatment of Transient Extreme Hypertriglyceridemia Associated with Diabetic Ketoacidosis and Acute Pancreatitis

摘要

Diabetic ketoacidosis (DKA) can quite frequently present in association with acute pancreatitis (AP) caused by transient severe hypertriglyceridemia (HTG). Here we report the case of a patient presenting with DKA, severe HTG and AP who received urgent plasma exchange for HTG control, and who reached adequate serum triglyceride levels only after appropriate DKA management. The treatment of patients presenting with DKA and coexistent AP associated with severe HTG should focus first on appropriate DKA management. Plasma exchange as a treatment for severe HTG in patients with DKA and AP should be evaluated carefully.LEARNING POINTS class="unordered" style="list-style-type:disc">The treatment of patients presenting with diabetic ketoacidosis, acute pancreatitis and severe hypertriglyceridemia should focus first on diabetic ketoacidosis management.Plasma exchange as a treatment for severe hypertriglyceridemia in patients with diabetic ketoacidosis and acute pancreatitis should be evaluated carefully.Triglyceride concentrations should always be measured in case of diabetic ketoacidosis. class="kwd-title">Keywords: Diabetic ketoacidosis, acute pancreatitis, hypertriglyceridemia, plasma exchange class="head no_bottom_margin" id="__sec2title">INTRODUCTIONDiabetic ketoacidosis (DKA) can quite often present in association with acute pancreatitis (AP) caused by transient severe hypertriglyceridemia (HTG) which is determined by DKA metabolic dysregulation^[]. Patients presenting with this particular triad of DKA, severe HTG and AP can be challenging since they must be appropriately managed. Here we report the case of a patient presenting with DKA, severe HTG and AP who received urgent plasma exchange for HTG control, and who reached adequate serum triglyceride levels only after appropriate DKA management.