Therapeutic plasma exchange in patients with severe hypertriglyceridemia: a multicenter study.

Abstract

Extremely high plasma triglyceride (TG) concentration is a recognized risk factor for acute pancreatitis (AP). In order to evaluate the therapeutic efficacy of plasma-exchange plasmapheresis in treating patients with severe hypertriglyceridemia (sHTG), 17 patients who had not responded to conventional medical therapy (fat-free diet plus pharmaceutical interventions) were referred for therapeutic plasma exchange (TPE) in a multicenter frame case series study. Two hundred seventeen TPE sessions were performed, and therapy is ongoing for five (30%) of the patients. After treatment, the mean plasma TG and total cholesterol concentrations were significantly reduced from 1929 and 510 mg/dL, to 762 and 227 mg/dL, respectively (P < or = 0.001 in both cases). In most cases, the interval between treatments was related to the clinical presentation and individual circumstances. The removal of TG-rich lipoproteins prevented relapses of AP. In this case series, TPE is confirmed as a safe and reliable method for treating patients with refractory sHTG when a severe complication, such as AP, is clinically demonstrated or can be actively prevented. Therefore, in cases where standard medical approaches fail to promote the clearance of TGs from plasma and a high risk of first or second hypertriglyceridemic pancreatitis persists, TPE provides a therapeutic option for preventing life-threatening sHTG.

• Authors: Claudia Stefanutti, Serafina Di Giacomo, Antonio Vivenzio, Giancarlo Labbadia, Fabio Mazza, Giovanna D'Alessandri, Giampaolo Russi, Giustina De Silvestro, Piero Marson
• Journal: Artificial organs (Artif Organs) Vol. 33 Issue 12 Pg. 1096-102 (Dec 2009) ISSN: 1525-1594 [Electronic] United States
• PMID: 20091936 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Triglycerides
• Cholesterol

Topics

• Acute Disease
• Adult
• Cholesterol (blood)
• Female
• Humans
• Hypertriglyceridemia (therapy)
• Male
• Middle Aged
• Plasma Exchange
• Recurrence
• Triglycerides (blood)