Publicação
Hypertriglyceridemic Pancreatitis: Conventional Treatment Versus Therapeutic Plasma Exchange
| Resumo: | Introduction: Acute pancreatitis (AP) induced by hypertriglyceridemia(HTG) can be treated with therapeutic plasma exchange(TPE), resulting in rapid reduction of triglyceride level.However, there are no definitive comparative studies thatprove the real benefits of this therapy.Objectives: Comparison of treatment methods (TPE versusconventional) in patients with HTG AP during a period of 12years (2000-2012).Methods: Retrospective, descriptive and inferential analysis of37 patients, evaluating: gender, age, personal pathologic history,severity of disease, HTG values and evolution dependingon treatment with therapeutic plasma exchange (“TPE”) orwith conventional therapy (“C”).Results: Both groups TPE and C demonstrated homogeneityconsidering gender (p = 0.647), age (43.5 ± 9.74 years TPE vs45.30 ± 9.90 years C; p = 0.320), prior AP episode (40% TPEvs 40.7% C; p = 1.0), chronic alcohol consumption (50% TPEvs 70.4% C; p = 0.275) and severity disease scores: APACHEII (p = 0.054) and Ranson (p = 0.258). More than one secondaryHTG risk factor was presented in 45.95% of patients. TPE group presented higher TG levels at admission: 4850± 2802 mg/dL vs 1845 ± 1858 mg/dL (p = 0.001). No significantstatistical differences were observed considering lengthof hospital stay [14.2 ± 6.8 days vs 13.5 ± 9.0 days (p = 0.56)]or mortality rate (p = 0.47). At discharge, TG reduction wasgreater in TPE group: 4433.70 ± 2896.08 mg/dL – 91.41% vs1582.95 ± 2051.06 mg/dL – 83,92% (p = 0.002). Six minorcomplications associated to TPE occurred.Discussion/Conclusion: Despite the selection bias (retrospectivestudy), a greater TG reduction was observed with TPEtechnique. Complications associated with the technique weresimple to resolve. |
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| Autores principais: | M. Ferreira, Diana |
| Outros Autores: | Lobo, Filipe; Fonseca, João Pedro; A. Mendes, Patrícia; Aragão, António; Ferreira, Manuela; Tomaz, Jorge; de Carvalho, Armando |
| Assunto: | Doença Aguda Hipertrigliceridémia/tratamento Pancreatite/tratamento Troca Plasmática Acute Disease hypertriglyceridemia/therapy Pancreatitis/ therapy Plasma Exchange |
| Ano: | 2017 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | unknown |
| Instituição associada: | Sociedade Portuguesa de Medicina Interna |
| Idioma: | inglês |
| Origem: | Revista Portuguesa de Medicina Interna |
| Resumo: | Introduction: Acute pancreatitis (AP) induced by hypertriglyceridemia(HTG) can be treated with therapeutic plasma exchange(TPE), resulting in rapid reduction of triglyceride level.However, there are no definitive comparative studies thatprove the real benefits of this therapy.Objectives: Comparison of treatment methods (TPE versusconventional) in patients with HTG AP during a period of 12years (2000-2012).Methods: Retrospective, descriptive and inferential analysis of37 patients, evaluating: gender, age, personal pathologic history,severity of disease, HTG values and evolution dependingon treatment with therapeutic plasma exchange (“TPE”) orwith conventional therapy (“C”).Results: Both groups TPE and C demonstrated homogeneityconsidering gender (p = 0.647), age (43.5 ± 9.74 years TPE vs45.30 ± 9.90 years C; p = 0.320), prior AP episode (40% TPEvs 40.7% C; p = 1.0), chronic alcohol consumption (50% TPEvs 70.4% C; p = 0.275) and severity disease scores: APACHEII (p = 0.054) and Ranson (p = 0.258). More than one secondaryHTG risk factor was presented in 45.95% of patients. TPE group presented higher TG levels at admission: 4850± 2802 mg/dL vs 1845 ± 1858 mg/dL (p = 0.001). No significantstatistical differences were observed considering lengthof hospital stay [14.2 ± 6.8 days vs 13.5 ± 9.0 days (p = 0.56)]or mortality rate (p = 0.47). At discharge, TG reduction wasgreater in TPE group: 4433.70 ± 2896.08 mg/dL – 91.41% vs1582.95 ± 2051.06 mg/dL – 83,92% (p = 0.002). Six minorcomplications associated to TPE occurred.Discussion/Conclusion: Despite the selection bias (retrospectivestudy), a greater TG reduction was observed with TPEtechnique. Complications associated with the technique weresimple to resolve. |
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