Therapeutic plasma exchange in hypertriglyceridemic patients

Authors: ILGIN YILDIRIM ŞİMŞİR, UTKU ERDEM SOYALTIN, BANU PINAR ŞARER YÜREKLİ, MEHMET ERDOĞAN, ŞEVKİ ÇETİNKALP, LÜTFİYE FÜSUN SAYGILI, AYHAN DÖNMEZ, AHMET GÖKHAN ÖZGEN

Abstract: Background/aim: High triglyceride (TG) levels are associated with increases in atherosclerotic cardiovascular disease (CVD), hepatic steatosis, and pancreatitis. Acute pancreatitis is a condition with high mortality. Therapeutic plasma exchange (TPE) in the treatment of hypertriglyceridemic pancreatitis (HTGP) is a rapid and effective treatment modality. In this study, the results of TPE were evaluated and the frequency of lipoprotein lipase (LPL) mutation in these patients was determined.Materials and methods: TPE was performed in 31 patients with HTGP at the Adult Therapeutic Apheresis Center.Results: A TG level under 500 mg/dL was achieved by applying apheresis at a median of 2 times (IQR 2-2, min 1, max 6) in the 31 cases. LPL mutation was detected in 8 (25.8%) of the 31 hypertriglyceridemia cases. When TG levels before and after TPE were evaluated, the mean TG level before TPE was significantly higher (3132 ± 1472 mg/dL) than the mean TG level afterwards (948 ± 465 mg/dL, P < 0.001). This result represented a decrease of 69.7% TG after TPE.Conclusion: TPE is a safe, fast, and effective treatment modality in experienced centers.

Keywords: Hypertriglyceridemia, pancreatitis, apheresis, therapeutic plasma exchange, fresh frozen plasma

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