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[heparin and insulin treatment of acute pancreatitis caused by hypertriglyceridemia. Experience of 5 cases].
Rev Med Chil. 2001 Dec; 129(12):1373-8.RM

Abstract

BACKGROUND

Hypertriglyceridemia over 1,000 mg/dl can provoke acute pancreatitis and its persistence can worsen the clinical outcome. On the contrary, a rapid decrease in triglyceride level is beneficial. Plasmapheresis has been performed in some patients to remove chylomicrons from the circulation, while heparin and/or insulin have been administered in some other cases to rapidly reduce blood triglycerides. Heparin and insulin stimulate lipoprotein-lipase activity and accelerate chylomicron degradation.

AIM

To report five patients with acute pancreatitis treated with heparin and insulin.

PATIENTS AND METHODS

Five patients (4 females and 1 male) seen in the last two years, who suffered acute pancreatitis induced by hypertriglyceridemia are reported. Initial blood triglyceride levels were above 1,000 mg/dl (range 1,590-8,690 mg/dl). Besides the usual treatment of acute pancreatitis, heparin and/or insulin were administered intravenously in continuous infusion. Heparin dose was guided by usual parameters of blood coagulation, and insulin dose, by serial determinations of blood glucose. Pancreatic necrosis was demonstrated in 4 patients.

RESULTS

Serum triglyceride levels decreased to < 500 mg/dl within 3 days in all cases. No complication of treatment was observed and all patients survived. Early and late complications of pancreatitis occurred in one patient.

CONCLUSION

Administration of heparin and/or insulin is an efficient alternative to reduce triglyceride levels in patients with acute pancreatitis and hypertriglyceridemia.

Authors+Show Affiliations

Sección de Gastroenterología, Unidad de Paciente Crítico, Hospital Clínico, Universidad de Chile, Santos Dumont 999. zberger@terra.clNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Clinical Trial
English Abstract
Journal Article

Language

spa

PubMed ID

12080874

Citation

Berger, Z, et al. "[heparin and Insulin Treatment of Acute Pancreatitis Caused By Hypertriglyceridemia. Experience of 5 Cases]." Revista Medica De Chile, vol. 129, no. 12, 2001, pp. 1373-8.
Berger Z, Quera R, Poniachik J, et al. [heparin and insulin treatment of acute pancreatitis caused by hypertriglyceridemia. Experience of 5 cases]. Rev Med Chil. 2001;129(12):1373-8.
Berger, Z., Quera, R., Poniachik, J., Oksenberg, D., & Guerrero, J. (2001). [heparin and insulin treatment of acute pancreatitis caused by hypertriglyceridemia. Experience of 5 cases]. Revista Medica De Chile, 129(12), 1373-8.
Berger Z, et al. [heparin and Insulin Treatment of Acute Pancreatitis Caused By Hypertriglyceridemia. Experience of 5 Cases]. Rev Med Chil. 2001;129(12):1373-8. PubMed PMID: 12080874.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [heparin and insulin treatment of acute pancreatitis caused by hypertriglyceridemia. Experience of 5 cases]. AU - Berger,Z, AU - Quera,R, AU - Poniachik,J, AU - Oksenberg,D, AU - Guerrero,J, PY - 2002/6/26/pubmed PY - 2002/8/8/medline PY - 2002/6/26/entrez SP - 1373 EP - 8 JF - Revista medica de Chile JO - Rev Med Chil VL - 129 IS - 12 N2 - BACKGROUND: Hypertriglyceridemia over 1,000 mg/dl can provoke acute pancreatitis and its persistence can worsen the clinical outcome. On the contrary, a rapid decrease in triglyceride level is beneficial. Plasmapheresis has been performed in some patients to remove chylomicrons from the circulation, while heparin and/or insulin have been administered in some other cases to rapidly reduce blood triglycerides. Heparin and insulin stimulate lipoprotein-lipase activity and accelerate chylomicron degradation. AIM: To report five patients with acute pancreatitis treated with heparin and insulin. PATIENTS AND METHODS: Five patients (4 females and 1 male) seen in the last two years, who suffered acute pancreatitis induced by hypertriglyceridemia are reported. Initial blood triglyceride levels were above 1,000 mg/dl (range 1,590-8,690 mg/dl). Besides the usual treatment of acute pancreatitis, heparin and/or insulin were administered intravenously in continuous infusion. Heparin dose was guided by usual parameters of blood coagulation, and insulin dose, by serial determinations of blood glucose. Pancreatic necrosis was demonstrated in 4 patients. RESULTS: Serum triglyceride levels decreased to < 500 mg/dl within 3 days in all cases. No complication of treatment was observed and all patients survived. Early and late complications of pancreatitis occurred in one patient. CONCLUSION: Administration of heparin and/or insulin is an efficient alternative to reduce triglyceride levels in patients with acute pancreatitis and hypertriglyceridemia. SN - 0034-9887 UR - https://www.unboundmedicine.com/medline/citation/12080874/[heparin_and_insulin_treatment_of_acute_pancreatitis_caused_by_hypertriglyceridemia__Experience_of_5_cases]_ L2 - http://www.diseaseinfosearch.org/result/9663 DB - PRIME DP - Unbound Medicine ER -