An interesting case of acute pancreatits

Hypertriglyceridemia(HTG)is the third most common cause of acute pancreatitis but it is relatively rare and requires a highlevel of clinic suspicion. We report a 30 years old male with no co-morbidities who is a non-alcoholic, non-smoker presented with epigastric pain associated with vomiting for two days. His vitals were stable and systemic examination wasunremarkable. Serum lipase levels were elevated [7365 U/l(<40 U/l)]. Computed Tomography of the abdomen suggested acute pancreatitis with extensive peri-pancreatic inflammatory changes with no evidence of pancreatic necrosis. Serum triglycerides were found to be elevated (3450 mg/dl). A diagnosis of HTGinduced acute pancreatitis was made. During evaluation he was found to be diabetic. He was treated with intravenous fluids, IV insulin infusion, and other supportive measures. He was started on statins, fenofibrate and omega3 fatty acids. His condition improved and triglyceride levels after two days were in a declining trend and he was discharged on the same. He was currently under follow up and his serum amylase, serum lipase, serum triglycerides were normal. This case report provides insight into rare cause of acute pancreatitis-HTGwhich if diagnosed at the earliest can be treated promptly.

A rare cause of anaemiain multiple myeloma

Multiple myeloma is a neoplastic plasma cell dyscrasia. Anaemiain multiple myeloma is usually related to many factors, of which the commonest cause being anaemiaof chronic disease. We reporteda 67 years old hypertensive male presented with low back pain and loss of appetite. Investigations revealed severe anaemiaand elevated total serum protein with albumin/globulin (A/G) reversal (1:4). Bone marrow aspiration revealed plasma cell dyscrasia. Skeletal survey evaluation showed multiple osteolytic lesions. Serum protein electrophoresis revealed M spike in gamma globulin region with immunofixation suggestive of IgG and kappa monoclonal gammopathy. He was diagnosed as a case of multiple myeloma.. On evaluating the cause of severe anaemia, interestingly various findings suggestive of Autoimmune hemolytic anaemia(AIHA) were found. Packed red blood cell transfusion along with steroids was done for correction of severe anaemia. Review of literature showed that only about 4% of AIHA patients had multiple myeloma. We reported a rare case of multiple myeloma who presented with AIHA.