Korean J Gastroenterol.  2010 Jun;55(6):399-403. 10.4166/kjg.2010.55.6.399.

Hypertriglyceridemia-Induced Pancreatitis Treated with Insulin in a Nondiabetic Patient

• Park SY
• Chung JO
• Cho DK
• Lee WS
• Kim HS
• Choi SK
• Rew JS
• Chung MY

• KMID: 948770
• DOI: http://doi.org/10.4166/kjg.2010.55.6.399

Abstract

Heparin and/or insulin stimulate lipoprotein lipase and are known to decrease serum triglyceride level. However, their efficacy in hypertriglyceridemia-induced acute pancreatitis in nondiabetic patients is not well documented. We report a case of hypertriglyceridemia-induced pancreatitis in 43-year-old nondiabetic woman in whom treatment with insulin was accompanied by reduction in serum triglyceride level and the resolution of pancreatitis. She presented to the emergency department with abdominal pain and biochemical evidence of acute pancreatitis. Her medical history was unremarkable. There was no history of alcohol consumption, and biliary imaging was not remarkable. Subsequent laboratory investigation revealed marked hypertriglyceridemia (1,951 mg/dL), impaired fasting glucose, and normal HbAlc level. The Ranson's score and APATCH II score were 1 and 4. Abdominal CT showed diffuse enlargement of pancreas, peripancreatic fat infiltration, and multiple fluid collections around the pancreas. We treated the patient with the infusion of 5% dextrose and 1.5 unit/hr regular insulin to reduce serum triglyceride level. The level of serum triglyceride was decreased to 305 mg/dL on day 5. During the remainder of hospitalization, her clinical symptoms and laboratory values gradually improved.

Keyword

Hypertriglyceridemia; Pancreatitis; Insulin

MeSH Terms

Acute Disease
Adult
Diabetes Mellitus/diagnosis
Female
Hemoglobin A, Glycosylated/analysis
Humans
Hypertriglyceridemia/*complications
Insulin/*therapeutic use
Pancreatitis/*drug therapy/etiology
Severity of Illness Index
Tomography, X-Ray Computed

Figure

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  Fig. 1. Lipoprotein electrophoresis. It showed type III hyperlipoproteinemia pattern during acute phase.

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  Fig. 2. Abdominal computed tomography (CT). (A) Initial abdominal CT showed diffuse enlargement of pancreas and peripancreatic fat infiltration. (B) It showed multiple fluid collections in the peripancreatic, perisplenic, and pararenal space.

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