Endocrine Abstracts

Objective: Severe hypertriglyceridemia is one of the leading causes of acute pancreatitis which is associated with increased mortality and morbidity. Here we evaluate the effectiveness of plasmapheresis on triglyceride levels in our group of patients who had plasmapheresis in our endocrinology clinic.

Method: We retrospectively evaluate clinical and laboratory reports between 2016–2018, for demographic parameters and the lipid levels before and immediately after the plasmapheresis session. Same double filtration plasmapheresis machine and same blood purificationand plasma seperator sets were used for all plasmapheresis sessions. Serum triglyceride, total cholesterol and HDL levels were measured with spectrophotometric analysis.

Results: We are presenting the results of 8 patients (F/M:4/4) and 31 session of plasmapheresis. All patients had severe hypertriglyceridemia, above 1000 mg/dl. Mean age was 43.5 years. 5 patients admitted to emergency clinic with acute pancreatitis and had plasmapheresis treatment. Two patients were pregnant, one of them admitted to emergency with pancreatitis and one of the pregnant patients was referred to our outpatient clinic with severe hypertriglyceridemia and had repetitive plasmapheresis up to delivery. One patient who had a history of 9 pancreatitis attack was taken to routine plasmapheresis program every 3 weeks. Mean serum triglyceride levels before and after plasmapheresis were 3399±1687 mg/dl and 2509±1559 mg/dl and there was a significant difference (P: 0.032). Mean serum HDL was 89.5±64.8 mg/dl before plasmapheresis and 70.4±58.7 mg/dl after plasmapheresis. Mean total cholesterol was 449±217 mg/dl before plasmapheresis and 370±208 mg/dl after plasmapheresis. The decrease in HDL and total cholesterol levels before and after plasmapheresis was not significant statistically. The mean decrease in triglyceride levels with plasmapheresis in this 31 session was % 24.5. Only in 5 session triglyceride levels decreased 50% or more. In 2 session we had triglyceride level <500 mg/dl after plasmapheresis.

Conclusion: We observed mild to moderate decrease in serum triglyceride levels after plasmapheresis in severe hypertriglyceridemia patients. Further clinical trials are needed to assess the effectiveness of plasmapheresis in managing hypertriglyceridemia and triglyceride induced acute pancreatitis.