Hypertriglyceridemia-induced pancreatitis in pregnancy. A case report

• Published in: Annales françaises d'anesthésie et de réanimation Vol. 26; no. 7-8; pp. 677 - 679
• Main Authors: Exbrayat, V, Morel, J, De Filippis, J-P, Tourne, G, Jospe, R, Auboyer, C
• Format: Journal Article
• Language: French
• Published: France 01.07.2007
• Subjects: Abdominal Pain - etiology; Acute Disease; Adult; Cesarean Section; Female; Fetal Distress - etiology; Fetal Distress - surgery; Humans; Hyperamylasemia - etiology; Hypercholesterolemia - complications; Hypertriglyceridemia - complications; Hypertriglyceridemia - therapy; Lipase - blood; Nausea - etiology; Pancreatitis - blood; Pancreatitis - diagnostic imaging; Pancreatitis - etiology; Pancreatitis - therapy; Plasmapheresis; Pregnancy; Pregnancy Complications - blood; Pregnancy Complications - diagnosis; Pregnancy Complications - diagnostic imaging; Pregnancy Complications - therapy; Radiography; Vomiting - etiology

We report the case of a 31-year-old pregnant patient in the 33rd week of gestation, with no history of dyslipidaemia, admitted for sub-acute epigastric pain. The milky aspect of blood samples was remarkable. Blood analysis showed a moderate increase in pancreatic enzymes but a major hyperlipaemia: triglyceridaemia 113 g/l and total cholesterolaemia 25 g/l. We suspected a hypertriglyceridemia-induced pancreatitis in pregnancy. The diagnosis was confirmed by CT-scan. Abdominal echography showed no abnormalities in biliary duct. After few hours, a caesarean was performed for acute fetal distress. The patient was admitted to the intensive care unit where a decrease of hypertriglyceridemia was already observed. Only one plasmapheresis was performed. Heparin was introduced. Rapid clinical improvement allowed discharge from intensive care at day 3. This case report illustrates lipid decrease with undertaken treatments. We discuss the management of hypertriglyceridemia-induced pancreatitis in pregnancy.