Tasty Morsels of Critical Care Tasty Morsels of Critical Care 089 | Hypertriglyceridemia-induced acute pancreatitis
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Sep 29, 2025 Dive into the intriguing world of hypertriglyceridemia-induced pancreatitis, where strikingly lipemic blood samples can be a diagnostic clue. Learn when to suspect this rare cause and how triglyceride levels directly correlate with the severity of pancreatitis. The discussion covers the toxic mechanisms of fatty acids and dives into acute management strategies, including nutrition adjustments and insulin use. Plus, explore plasmapheresis as a rapid triglyceride-lowering option, even as guidelines caution against its routine use in acute scenarios.
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Think High Triglycerides When Usual Causes Absent
- Hypertriglyceridemia is an uncommon but real cause of pancreatitis that ranges widely in reported frequency.
- Consider it when gallstones and alcohol are absent because true incidence estimates vary widely.
Lab Calls Over Milky Blood
- The host has seen cases where the lab called because blood was so lipemic it could not be processed.
- They note the striking appearance of lipemic blood and compare it to methaemoglobinemia as visually diagnostic.
Severity Correlates With Triglyceride Levels
- Higher triglyceride levels generally correlate with more severe pancreatitis.
- The pathogenesis likely involves toxic free fatty acids produced by lipase activity rather than triglycerides themselves.