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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2022; 05(03): 119-121
DOI: 10.1055/s-0042-1757702
Case Report

Acute Pancreatitis Secondary to Hypertriglyceridemia during Pregnancy

Raed Alenezi
1   Specialty Medicine Department, John Hopkins Aramco Health Care, Dhahran, Saudi Arabia
2   College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
3   King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
,
Waleed M. Almutairi
4   Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
,
Najla Saleh
2   College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
3   King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
,
Raed Aldahash
2   College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
3   King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
4   Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
,
Yousef Al-Saleh
2   College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
3   King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
4   Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
5   College of Science, King Saud University, Riyadh, Saudi Arabia
› Author Affiliations Funding and Sponsorship None.
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Abstract

Introduction Hypertriglyceridemia (HTG) (triglycerides > 1,000 mg/dL [11.3 mmol/L]) has been associated with a high risk of developing acute pancreatitis (AP) in pregnant women, but this condition is rare. We present the case of a pregnant Saudi with AP secondary to HTG.

Case Report A 27-year-old Saudi female presented at 30 weeks' gestational age with abdominal pain, nausea, and vomiting of 4 days' duration. AP was diagnosed based on clinical presentation, high lipase, and abdominal ultrasound findings. Her triglyceride level was 58 mmol/L. Fenofibrate and intravenous regular insulin infusion with dextrose were started, which decreased triglycerides by the third day from 58.8 to 29 mmol/L (50% reduction) with a further reduction to 11 mmol/L (81%) by day 7 of her admission. Labor was induced at 37 weeks of gestation, and she delivered a healthy neonate.

Conclusion We report successful treatment of AP in pregnancy with intravenous insulin and fenofibrate. Several case reports have discussed the therapeutic option of AP induced by HTG in pregnancy. Lipid-lowering agents are category C in pregnancy. However, few case reports indicate their safety. Insulin, heparin, and apheresis have also been used during pregnancy without any complications.

Keywords

acute pancreatitis - hypertriglyceridemia - pregnancy

Consent

The patient consented prior to reporting the case.


Authors' Contributions

All named authors contributed to the conduct of the work, drafting, and finalization of the manuscript and approved its final version.


Compliance with Ethical Principles

No prior ethical approval is required for single case reports or small case series.




Publication History

Article published online:
05 December 2022

© 2023. Gulf Association of Endocrinology and Diabetes (GAED). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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