Hypertriglyceridemia-Induced Acute Pancreatitis During Pregnancy: A Case Report.

Division

South Atlantic

Hospital

Memorial Health University Medical Center

Document Type

Case Report

Publication Date

8-22-2022

Keywords

hypertriglyceridemia-induced acute pancreatitis, hypertrygliceridemic pancreatitis, idiopathic pancreatitis in pregnancy, pancreatitis in pregnancy, severe hypertriglyceridemia

Disciplines

Digestive System Diseases | Nutritional and Metabolic Diseases | Obstetrics and Gynecology

Abstract

Hypertriglyceridemia-induced acute pancreatitis is a rare and serious condition that places both the mother and the fetus at severe risk for morbidity and mortality. The goal of this case report is to describe the management of a pregnant patient with severely elevated triglycerides in the setting of acute pancreatitis. A 28-year-old female G2P1001 at 29 weeks of gestational age presented with epigastric abdominal pain. A computed tomography scan of the abdomen and pelvis with contrast demonstrated acute interstitial edematous pancreatitis. A lipid panel was performed, revealing a serum triglyceride level of 3,949 mg/dL. Insulin and maternal bowel rest reduced her serum triglyceride levels; however, additional medical therapy including fibrate and statin drugs were initiated to achieve goal levels of triglycerides and improve patient symptoms. The patient ultimately recovered and remained on treatment until delivery. Initial management addresses acute pancreatitis and involves fluid resuscitation, pain control, and bowel rest. Triglyceride-lowering drug therapies are rarely used during pregnancy due to the potential for fetal teratogenicity; however, given the severity of hypertriglyceridemia fenofibrate and atorvastatin were prescribed. Additional medical treatment included insulin, omega-3, and ethyl eicosapentaenoic acid.

Publisher or Conference

Cureus

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