Therapeutic plasma exchange in the setting of recurrent acute pancreatitis secondary to hypertriglyceridemia: A case report

Abstract

Acute pancreatitis has many etiological factors, with the most common metabolic cause being hypertriglyceridemia. While it is considered one of the top causes, the management of refractory hypertriglyceridemia in the setting of pancreatitis lacks clear guidelines and protocols. Urgent reduction in triglyceride levels may be desirable to alleviate symptoms. Therapeutic plasma exchange has been used as an emergent therapy in recurrent pancreatitis, with associated improvement in the patient’s clinical presentation and pancreatic-damage-associated laboratory parameters (e.g., lipase and amylase). Mortality benefit from plasma exchange has however not been demonstrated.  We, therefore, present a case of a patient with recurrent acute pancreatitis secondary to hypertriglyceridemia, who was managed medically and subsequently referred for therapeutic plasma exchange due to persistently elevated triglycerides, with symptomatic relief.