ABSTRACT
Severe Hypertriglyceridemia (HTG) is associated with complications such as acute pancreatitis (AP) with high morbidity and mortality rates. We report a 42 years-old man with refractory HTG diagnosed at 19 years of age, and multiple episodes of AP, admitted with the suspicion of a new AP episode. Serum triglycerides were over 2000 mg/dl. His body mass index was 18 kg/m2, there was no evidence of xanthomas or xanthelasmas, but lipemia retinalis was found. Management included heparin and insulin, added to his usual treatment with fibrates, statins, omega-3 fatty acids, and orlistat. Due to lack of response, apheresis was started. After five sessions, triglycerides decreased to 588 mg/dl (82% reduction) and levels remained below 1000 mg/dl with daily apheresis. The patient continued with weekly sessions as outpatient with a sustained good response.
Subject(s)
Adult , Humans , Male , Pancreatitis , Blood Component Removal , Hypertriglyceridemia , Hyperlipidemias , Pancreatitis/therapy , Triglycerides , Hypertriglyceridemia/therapy , Acute DiseaseABSTRACT
El "Drop Attacks" denominado también crisis de desplome o crisis de caída, se define como caída brusca, sin advertencia, sin causa externa y sin alteración de conciencia, es un fenómeno poco conocido por el clínico general que muestra clara preferencia por el sexo femenino. Se presenta un análisis descriptivo de 8 casos que consultaron directamente o que refirieron crisis de caída durante 1989. La historia detallada, personal y familiar de cada paciente se registró en un protocolo encuesta especialmente confeccionado para el estudio. En cada caso se realizó un electrocardiograma que fue normal. Se analiza la etiopatogenia del fenómeno y se señalan variaciones de la modalidad clásica de caída