{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:05:32Z","timestamp":1792098332092,"version":"4.4.0"},"reference-count":26,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,10,28]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>Acute pancreatitis (AP) is a potentially life-threatening complication of severe hypertriglyceridaemia, which is the third most common cause of AP after gallstone disease and alcohol excess. Standard therapy involves the use of lipid-lowering agents, low-molecular-weight heparin and insulin infusion. In some cases, when standard medical therapies fail, non-pharmacological methods based on the removal of triglycerides with therapeutic plasma exchange can provide positive results in the acute phase. There are currently no guidelines covering management in the acute phase, however, these approaches should be considered in severe or very severe hypertriglyceridaemia. Here, we report the case of a 37-year-old man with recurrent AP due to hypertriglyceridaemia and review the literature.<\/jats:p>","DOI":"10.1136\/bcr-2018-227594","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T17:19:47Z","timestamp":1545153587000},"page":"e227594","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Management of hypertriglyceridaemic pancreatitis in the acute setting and review of literature"],"prefix":"10.1136","volume":"11","author":[{"given":"Suhaniya","family":"Samarasinghe","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Northwick Park Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parizad","family":"Avari","sequence":"additional","affiliation":[{"name":"Division of Diabetes Endocrinology and Metabolism, Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Meeran","sequence":"additional","affiliation":[{"name":"Division of Diabetes Endocrinology and Metabolism, Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaimini","family":"Cegla","sequence":"additional","affiliation":[{"name":"Division of Diabetes Endocrinology and Metabolism, Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,11,28]]},"reference":[{"key":"2025082700223474000_11.1.e227594.1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12008"},{"key":"2025082700223474000_11.1.e227594.2","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-200204000-00020"},{"key":"2025082700223474000_11.1.e227594.3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-3213"},{"key":"2025082700223474000_11.1.e227594.4","first-page":"18","article-title":"Treatment of hypertriglyceridemia-induced acute pancreatitis with insulin","volume":"10","author":"Coskun","year":"2015","journal-title":"Prz Gastroenterol"},{"key":"2025082700223474000_11.1.e227594.5","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-200301000-00016"},{"key":"2025082700223474000_11.1.e227594.6","first-page":"117","article-title":"Pathogenesis, differentiation and management of hypertriglyceridemia","volume":"15","author":"Havel","year":"1969","journal-title":"Adv Intern Med"},{"key":"2025082700223474000_11.1.e227594.7","unstructured":"Brunzell JD . et al Familial Lipoprotein Lipase Deficiency, Apo C-II Deficiency, and Hepatic Lipase Deficiency | The Online Metabolic and Molecular Bases of Inherited Disease | OMMBID. 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The Metabolic and Molecular Bases of Inherited Disease. 8edn: McGraw-Hill Medical, 2001:2789\u2013816."},{"key":"2025082700223474000_11.1.e227594.8","first-page":"245","article-title":"The interaction of familial and secondary causes of hypertriglyceridemia: role in pancreatitis","volume":"86","author":"Brunzell","year":"1973","journal-title":"Trans Assoc Am Physicians"},{"key":"2025082700223474000_11.1.e227594.9","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.4558"},{"key":"2025082700223474000_11.1.e227594.10","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/clinchem\/39.2.234","article-title":"The clinical chemistry laboratory and acute pancreatitis","volume":"39","author":"Wong","year":"1993","journal-title":"Clin Chem"},{"key":"2025082700223474000_11.1.e227594.11","first-page":"016","article-title":"Possible mechanisms of normal amylase activity in hyperlipemic pancreatitis","volume":"1","author":"Mishkin","year":"1976;115","journal-title":"Can Med Assoc J"},{"key":"2025082700223474000_11.1.e227594.12","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(67)90077-0"},{"key":"2025082700223474000_11.1.e227594.13","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1007\/s10620-017-4602-2","article-title":"Chronic Pancreatitis: Current Status and Challenges for Prevention and Treatment","volume":"62","author":"Lew","year":"2017","journal-title":"Dig Dis Sci"},{"key":"2025082700223474000_11.1.e227594.14","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/S0140-6736(03)14234-1","article-title":"Dyslipidaemia","volume":"362","author":"Durrington","year":"2003","journal-title":"The Lancet"},{"key":"2025082700223474000_11.1.e227594.15","doi-asserted-by":"publisher","DOI":"10.1172\/JCI110547"},{"key":"2025082700223474000_11.1.e227594.16","first-page":"235","article-title":"[Insulin therapy in patients with severe hypertriglyceridemia]","volume":"44","author":"Tamez-P\u00e9rez","year":"2006","journal-title":"Rev Med Inst Mex Seguro Soc"},{"key":"2025082700223474000_11.1.e227594.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2005.02.036"},{"key":"2025082700223474000_11.1.e227594.18","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.4067\/S0034-98872001001200002","article-title":"[heparin and insulin treatment of acute pancreatitis caused by hypertriglyceridemia. 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