| Hypertriglyceridemia-induced acute pancreatitis treated with insulin and heparin. | |
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MedLine Citation:
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PMID: 22261942 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: A case of hypertriglyceridemia-induced acute pancreatitis that was managed with insulin and heparin is reported. SUMMARY: A 39-year-old Hispanic man arrived at the emergency department with complaints of abdominal pain, nausea, and vomiting over one day. A computed tomography scan of the abdomen revealed peripancreatic inflammatory changes surrounding the tail of the pancreas, consistent with pancreatitis. Pertinent laboratory test values on admission were as follows: triglyceride concentration, 5366 mg/dL; total cholesterol concentration, 555 mg/dL; amylase concentration, 131 units/L; lipase concentration, 51 units/L; serum glucose concentration, 253 mg/dL; and serum sodium concentration, 128 mmol/L. The patient was diagnosed with hypertriglyceridemia-induced pancreatitis. On hospital day 1, the patient was given nothing by mouth and received a 1-L bolus dose of 0.9% sodium chloride injection, followed by a continuous infusion of 0.9% sodium chloride injection at a rate of 125 mL/hr. Subcutaneous heparin 5000 units every eight hours, sliding-scale regular insulin, and gemfibrozil 600 mg twice daily were initiated. On hospital day 2, the patient's triglyceride concentration decreased to 2962 mg/dL, and his blood glucose concentration was 147 mg/dL. Subcutaneous insulin detemir 25 units daily was ordered, and sliding-scale insulin was continued. Due to continued elevated triglyceride levels, the patient was transitioned from subcutaneous insulin to an i.v. insulin infusion at 0.1 unit/kg/hr in addition to an infusion of 5% dextrose. On hospital day 5, the patient's triglyceride concentration decreased to 717 mg/dL; the insulin-dextrose infusion was discontinued. The patient was discharged on hospital day 6. CONCLUSION: A 39-year-old man with pancreatitis caused by severe hypertriglyceridemia was treated with a continuous insulin infusion and subcutaneous heparin. |
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Authors:
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Jennifer D Twilla; Jimmie Mancell |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists Volume: 69 ISSN: 1535-2900 ISO Abbreviation: Am J Health Syst Pharm Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-01-20 Completed Date: 2012-05-09 Revised Date: 2012-08-31 |
Medline Journal Info:
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Nlm Unique ID: 9503023 Medline TA: Am J Health Syst Pharm Country: United States |
Other Details:
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Languages: eng Pagination: 213-6 Citation Subset: IM |
Affiliation:
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Methodist University Hospital, 1265 Union Avenue, Memphis, TN 38104, USA. jennifertwilla@mlh.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Anticoagulants / administration & dosage, therapeutic use Gemfibrozil / therapeutic use Heparin / administration & dosage, therapeutic use* Humans Hypertriglyceridemia / complications*, drug therapy, physiopathology Hypoglycemic Agents / administration & dosage Hypolipidemic Agents / therapeutic use Infusions, Intravenous Injections, Subcutaneous Insulin / administration & dosage, therapeutic use* Male Pancreatitis / drug therapy*, etiology, physiopathology Severity of Illness Index |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Hypoglycemic Agents; 0/Hypolipidemic Agents; 0/Insulin; 25812-30-0/Gemfibrozil; 9005-49-6/Heparin |
| Comments/Corrections | |
Comment In:
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Am J Health Syst Pharm. 2012 Jul 15;69(14):1187-8
[PMID:
22761068
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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