{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:13:28Z","timestamp":1787314408246,"version":"build-2736575974"},"reference-count":5,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This case report describes therapeutic plasma exchange as treatment for a rare instance of severe hypertriglyceridemia following high\u2010dose intravenous lipid emulsion (ILE) therapy for bupivacaine\u2010induced local anesthetic systemic toxicity (LAST). The patient received a cumulative ILE dose of 28.0\u2009mL\/kg to control seizures, exceeding the typical recommended maximum dose of 10\u2009mL\/kg. Clinical presentation included severe headache, visual disturbances, and photophobia, concerning for hyperviscosity syndrome. Laboratory findings revealed a markedly elevated serum triglyceride concentration (&gt;\u200910\u2009350\u2009mg\/dL). Therapeutic plasma exchange with plasma was successfully employed to rapidly reduce serum triglycerides and alleviate symptoms. This case highlights the potential for severe iatrogenic hypertriglyceridemia associated with high\u2010dose ILE therapy for LAST and emphasizes the importance of close clinical monitoring and timely intervention.<\/jats:p>","DOI":"10.1002\/jca.70025","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T02:14:16Z","timestamp":1745288056000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Antidote Worse Than the Poison? Emergent Therapeutic Plasma Exchange After Overzealous Intravenous Lipid Emulsion Infusion During Treatment of Local Anesthetic Systemic Toxicity"],"prefix":"10.1002","volume":"40","author":[{"given":"Brooke","family":"Yasgur","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2749-0217","authenticated-orcid":false,"given":"Ari","family":"Filip","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratheepa","family":"Ravikumar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Department of Pediatrics University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5580-3524","authenticated-orcid":false,"given":"Logan","family":"Meurer","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4492-1787","authenticated-orcid":false,"given":"Gina","family":"Drobena","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-016-0550-z"},{"key":"e_1_2_6_3_1","volume-title":"Goldfrank's Toxicologic Emergencies","author":"Nelson L. S.","year":"2019"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.01.020"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2015.02.010"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21705"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.70025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T04:55:32Z","timestamp":1749185732000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.70025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":5,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/jca.70025"],"URL":"https:\/\/doi.org\/10.1002\/jca.70025","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2025-01-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70025"}}