Heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: Experiencia en 5 casos

Background: Hypertriglyceridemia over 1,000 mg/dl can provoke acute pancreatitis and its persistence can worsen the clinical outcome. On the contrary, a rapid decrease in triglyceride level is beneficial. Plasmapheresis has been performed in some patients to remove chylomicrons from the circulation,...

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Autores principales:	Berger F,Zoltán, Quera P,Rodrigo, Poniachik T,Jaime, Oksenberg R,Danny, Guerrero P,Julia
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2001
Materias:	Heparin Hypertrigliceridemia Insulin Pancreatitis, acute necrotizing
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001001200002
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spelling	oai:scielo:S0034-988720010012000022005-11-22Heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: Experiencia en 5 casosBerger F,ZoltánQuera P,RodrigoPoniachik T,JaimeOksenberg R,DannyGuerrero P,Julia Heparin Hypertrigliceridemia Insulin Pancreatitis, acute necrotizing Background: Hypertriglyceridemia over 1,000 mg/dl can provoke acute pancreatitis and its persistence can worsen the clinical outcome. On the contrary, a rapid decrease in triglyceride level is beneficial. Plasmapheresis has been performed in some patients to remove chylomicrons from the circulation, while heparin and/or insulin have been administered in some other cases to rapidly reduce blood triglycerides. Heparin and insulin stimulate lipoprotein-lipase activity and accelerate chylomicron degradation. Aim: To report five patients with acute pancreatitis treated with heparin and insulin. Patients and methods: Five patients (4 females and 1 male) seen in the last two years, who suffered acute pancreatitis induced by hypertriglyceridemia are reported. Initial blood triglyceride levels were above 1,000 mg/dl (range 1,590-8,690 mg/dl). Besides the usual treatment of acute pancreatitis, heparin and/or insulin were administered intravenously in continuous infusion. Heparin dose was guided by usual parameters of blood coagulation, and insulin dose, by serial determinations of blood glucose. Pancreatic necrosis was demonstrated in 4 patients. Results: Serum triglyceride levels decreased to <500 mg/dl within 3 days in all cases. No complication of treatment was observed and all patients survived. Early and late complications of pancreatitis occurred in one patient. Conclusion: Administration of heparin and/or insulin is an efficient alternative to reduce triglyceride levels in patients with acute pancreatitis and hypertriglyceridemia (Rev Méd Chile 2001; 129: 1373-8)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.129 n.12 20012001-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001001200002es10.4067/S0034-98872001001200002
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Heparin Hypertrigliceridemia Insulin Pancreatitis, acute necrotizing
spellingShingle	Heparin Hypertrigliceridemia Insulin Pancreatitis, acute necrotizing Berger F,Zoltán Quera P,Rodrigo Poniachik T,Jaime Oksenberg R,Danny Guerrero P,Julia Heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: Experiencia en 5 casos
description	Background: Hypertriglyceridemia over 1,000 mg/dl can provoke acute pancreatitis and its persistence can worsen the clinical outcome. On the contrary, a rapid decrease in triglyceride level is beneficial. Plasmapheresis has been performed in some patients to remove chylomicrons from the circulation, while heparin and/or insulin have been administered in some other cases to rapidly reduce blood triglycerides. Heparin and insulin stimulate lipoprotein-lipase activity and accelerate chylomicron degradation. Aim: To report five patients with acute pancreatitis treated with heparin and insulin. Patients and methods: Five patients (4 females and 1 male) seen in the last two years, who suffered acute pancreatitis induced by hypertriglyceridemia are reported. Initial blood triglyceride levels were above 1,000 mg/dl (range 1,590-8,690 mg/dl). Besides the usual treatment of acute pancreatitis, heparin and/or insulin were administered intravenously in continuous infusion. Heparin dose was guided by usual parameters of blood coagulation, and insulin dose, by serial determinations of blood glucose. Pancreatic necrosis was demonstrated in 4 patients. Results: Serum triglyceride levels decreased to <500 mg/dl within 3 days in all cases. No complication of treatment was observed and all patients survived. Early and late complications of pancreatitis occurred in one patient. Conclusion: Administration of heparin and/or insulin is an efficient alternative to reduce triglyceride levels in patients with acute pancreatitis and hypertriglyceridemia (Rev Méd Chile 2001; 129: 1373-8)
author	Berger F,Zoltán Quera P,Rodrigo Poniachik T,Jaime Oksenberg R,Danny Guerrero P,Julia
author_facet	Berger F,Zoltán Quera P,Rodrigo Poniachik T,Jaime Oksenberg R,Danny Guerrero P,Julia
author_sort	Berger F,Zoltán
title	Heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: Experiencia en 5 casos
title_short	Heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: Experiencia en 5 casos
title_full	Heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: Experiencia en 5 casos
title_fullStr	Heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: Experiencia en 5 casos
title_full_unstemmed	Heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: Experiencia en 5 casos
title_sort	heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: experiencia en 5 casos
publisher	Sociedad Médica de Santiago
publishDate	2001
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001001200002
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Heparina e insulina en el tratamiento de la pancreatitis aguda por hipertrigliceridemia: Experiencia en 5 casos

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