Early plasmapheresis in patients with severe hypertriglyceri
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Case
A 34-year-old female uncontrolled type II diabetes mellitus, obese (body mass index [BMI] 39/kg/m2) admitted with pain in epigastric region and vomiting since 3 days. On examination patient had pulse 135/min, respiratory rate (RR) 32/min, blood pressure (BP) 88/46 mm of Hg, with normal respiratory and cardiovascular examination on auscultation, abdominal distention, epigastric tenderness and guarding. She was admitted in intensive care unit (ICU), with APACHE II score 14, started on fluid resuscitation and other supportive management. Her ultrasound abdomen showed diffusely enlarged pancreas with fat stranding. Her arterial blood gas (ABG) showed severe anion gap metabolic acidosis. The blood was highly lipemic and on ultracentrifuge showed TG 9230 mg/dL [Table 1]. She had no history of alcohol use, drug intake, gallstones, and pancreatitis. The patient was managed as SHTG induced SAP and diabetic ketoacidosis with enteral fenofibrate other supportive management....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548421/
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