Aralik 2017
Hipertrigliseridemiye bagli akut pankreatitli hastalarimiz ve plazmaferez deneyimimiz
Our experience on patients with hypertriglyceridemia-induced acute pancreatitis and plasmapheresis
- Ana Sayfa
- Sayılar
- Aralik 2017
- Hipertrigliseridemiye bagli akut pankreatitli hastalarimiz ve plazmaferez deneyimimiz ...
Özet
Giris ve Amaç: Akut pankreatitin %1-5 nedeni hipertrigliseridemidir.Insülin infüzyonu, heparin infüzyonu ve plazmaferez hipertrigliseridemiye bagli akut pankreatitin tedavisinde yer almaktadir. Biz bu çalismamizda hipertrigliseridemiye bagli olusan akut pankreatitli hastalarimi-zin demografik özelliklerini, pankreatitlerinin seyrini, uygulanan tedaviyöntemlerini ve plazmaferezin etkinligini arastirdik. Gereç ve Yöntem:Türkiye Yüksek Ihtisas Hastanesi Gastroenteroloji Klinigi’nde 2012-2016yillari arasinda akut pankreatit tanisi konulan hastalar retrospektif olarak tarandi. Ilk basvuruda trigliserid degeri 900 mg/dl ve üzeri olanhastalar, diger etiyolojik nedenlerin yoklugunda hipertrigliseridemiyebagli akut pankreatit olarak kabul edildi. Hastalarin medikal bilgilerinehasta dosyalari ve hastane otomasyon bilgi sisteminden ulasildi.Bulgular: Toplam 10 hasta (E/K: 4/6, yas ortalamasi 41,4 (26-51) çalismayaalindi. Hastalarimizda akut pankreatit atak sikligi 1,4 (1-3) olarak bulundu. Akut pankreatit siddetini belirlemede BISAP skorlamasi kullanildi.BISAP skoru yüksek olan hastalara plasmaferez uygulandi (4 hasta). Buhastalarin 3 tanesinde psödokist ve walled-off nekroz olustugu görüldü.Walled-off nekroz olusan bir hastaya perkütan drenaj yapildi. Toplamda hiçbir hastada mortalite izlenmedi. Sonuç: Hipertrigliseridemi, digernedenlere kiyasla akut pankreatite nadiren yol açar. Bu hastalarin erkentaninmasi ve uygun tedavisi hastalik iliskili morbidite ve mortaliteninazalmasina yol açar. Plazmaferez özellikle ciddi seyreden hastalarda etkili bir tedavi yöntemidir.
Abstract
Background and Aims: Hypertriglyceridemia is an etiologic cause ofacute pancreatitis, with a frequency of 1%-5%. Insulin infusion, heparin infusion, and plasmapheresis can be used for the treatment ofacute pancreatitis related to hypertriglyceridemia. The aim of our studywas to share our experience with the treatment, clinical course, anddemographic features of patients with acute pancreatitis related to hypertriglyceridemia and the effectiveness of plasmapheresis. Materialand Methods: Patients with acute pancreatitis diagnosed and treatedat Türkiye Yüksek Ihtisas Training and Research Hospital during 2014-2016 were screened. Those who had hypertriglyceridemia with levels>900 mg/dl without any potential cause of acute pancreatitis were included in the study as patients with hypertriglyceridemia-induced acutepancreatitis. Medical data were collected from patients’ files and thehospital computer automation system. Results: A total of 10 patients[male/female: 4/6, median age: 41.4 (26-51) years] were included inthe study. The frequency of acute pancreatitis was 1.4. The BedsideIndex of Severity in Acute Pancreatitis scoring system was used to establish the severity of acute pancreatitis. Patients with a high BedsideIndex of Severity in Acute Pancreatitis score were treated with plasmapheresis (n=4). In this group, three patients developed walled off necrosis and pseudocysts. Percutaneous drainage was applied in one patientwith walled off necrosis. No mortality was observed in our patients.Conclusion: Hypertriglyceridemia is a rare cause of acute pancreatitis.Early diagnosis and appropriate treatment are important in this groupfor decreasing the disease-related morbidity and mortality. Plasmapheresis is an effective treatment modality, especially in patients with severehypertriglyceridemia-induced acute pancreatitis.
