Hypertriglyceridemia-Induced Acute Pancreatitis: a case repo
The present case has been published in the American Journal of Medicine.

A 42-year-old man presented with severe abdominal pain of 48 hours' duration. He had no history of alcohol use and pancreatitis. His laboratory tests showed leukocytosis (13.1 × 109/L) and very severe hypertriglyceridemia (2275 mg/dL). C-reactive protein was elevated at 34.06 mg/dL (reference range, < 0.3 mg/dL). His serum amylase and lipase levels were 12 U/L (reference range 43-116 U/L) and 41 U/L (reference range 5-50 U/L), respectively.

Contrast-enhanced computed tomography showed significant peripancreatic infiltration around the pancreatic head with fluid accumulation compatible with the diagnosis of acute pancreatitis. On admission, other serum pancreatic enzymes were evaluated to strengthen the diagnosis of acute pancreatitis.

However, none of the serum enzymes were elevated: trypsin 160 ng/mL (reference range 100-550 ng/mL), elastase-1 80 ng/dL (reference range < 300 ng/dL), and phospholipase A2 173 ng/dL (130-400 ng/dL). Based on his clinical, laboratory, and imaging findings, there was no evidence of biliary pancreatitis or chronic pancreatitis.

The patient was diagnosed with hypertriglyceridemia-induced acute pancreatitis and treated with bowel rest with intravenous hydration and pain control. His symptoms continued to improve without complication, and serum levels of pancreatic enzymes remained normal throughout the hospitalization. The patient was discharged home on day 17 with medication of bezafibrate.

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