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INTRODUCTION: Acute pancreatitis (AP) is considered one of the potentially rare complications of severe hypertriglyceridemia (HTG). Multiple treatment modalities have been suggested for patients with HTG-AP, such as permanent removal of TG by plasmapheresis, the use of insulin and heparin to enhance lipoprotein lipase activity and fibrate therapy, but the data remains limited. CASE MANAGEMENT: we reported a case of 33-year-old women admitted for HTG-induced PA (HTG-AP). The patient had hypertriglyceridemia for 7 years under fibrate therapy as a medical history. On admission to our intensive care unit, his triglyceride level was 1060 mg/dl and the lipase level was 298 IU/L. An abdominal CT scan revealed stage E AP. The patient was treated with a low dose insulin infusion (0.05 unit/kg/h) with heparin and 5-day course of plasmapheresis, Fibrate therapy was maintained. His triglycerides went down to 130.9 mg/dl and she was discharged. CONCLUSION: Early recognition of severe HTG can prevent progression to multiples diseases such as acute pancreatitis, can facilitate appropriate or even aggressive treatment to minimize complications of this.
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BACKGROUND: Lymphopenia is one of features that helps identify patients with severe Covid-19. This retrospectively study analyzed the association of lymphopenia with the severity of COVID-19 infection, determinate the predictive factors of lymphopenia and the significance of mortality in patient with lymphopenia. METHODS: This retrospective study included patients diagnosed with Covid-19 and admitted to intensive care unit of our university hospital center From Mars 1st 2020, to December 31st, 2020. RESULTS: In this study, 589 patients were included, a group had lymphopenia with 357 cases (60.06%) and the non-lymphopenia group with 232 cases (39.4%). The median age of our patients having lymphopenia was 65 years (56-76). Hypertension and diabetes were noted in the majority of patients with lymphopenia than in the non-lymphopenia group. Lymphopenia was strongly correlated to the inflammatory biomarkers of COVID-19 and were significant. A significant correlation was found between lymphopenia group and CT scan. Lymphopenia was observed as an indicator of prolonged duration of hospitalization but was not significant. CONCLUSION: Analytical data from this retrospective study shows the importance in the association between lymphopenia and the severity of COVID-19 infection, hence the need for dynamic monitoring of the number of lymphocytes on admission and during hospitalization of these patients.
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INTRODUCTION: Although the corona virus is responsible in the majority of cases for mild symptoms, there are sometimes severe and even lethal forms of this disease. Our study aimed to identify clinical and para-clinical predictors of mortality related to COVID-19. MATERIALS AND METHODS: This is a single-center retrospective cohort study conducted from March 2020 to December 2020 at intensive care unit department of Mohamed VI University Hospital Oujda, Morocco including 600 patients with COVID-19. RESULTS: We included 600 patients, the mortality rate was 32.50%, the predictors of mortality identified in our study were: associated heart disease (RR: 1.826; CI: [1.081-3.084]; p:0.024), high D-dimer level at admission (RR:1.027; CI: [1.011-1.047]; p:0.001), need for mechanical ventilation (RR: 4.158; CI: [2.648-6.530]; p: <0.0001). CONCLUSION: Based on these results, we were able to identify 3 predictors of COVID 19 mortality (associated heart failure, high D-dimer level on admission, and need for mechanical ventilation). These predictors could help clinicians to identify early patients with high risk of lethality in order to reduce mortality related to corona virus.
