Application of Lipid Apheresis in Acute Lipogenic Pancreatitis.

Introduction: Recently, the incidence of hypertriglyceridemia-associated pancreatitis (HTG-AP) has been increasing. The pathogenesis of lipogenic pancreatitis is not fully understood. This study aimed to retrospectively analyze the laboratory data, clinical manifestations, and prognosis of patients with lipid-derived pancreatitis who received lipid purification, to explore whether lipid purification is a better treatment for acute hyperlipidemic pancreatitis. Methods: In this study, we enrolled five subjects diagnosed with HTG-AP at the Second Xiangya Hospital of Central South University between 2021 and 2022. We collected demographic data, medical histories, clinical manifestations, and laboratory data. All patients received routine therapy. Blood lipid purification was conducted using the double filtration plasmapheresis (DFPP) method. Plasma was separated from blood cells and purified to remove cholesterol, triglycerides, and low-density lipoprotein (LDL). SPSS was used for statistical analyses. Results: Following a single lipoprotein apheresis (LA) treatment, significant improvements in serum lipid levels were observed. Three patients achieved triglyceride levels below 5.65 mmol/L within 24 h, while the remaining 2 patients experienced reductions of 82% and 78%, respectively. The average triglyceride level decreased from 36.82 to 7.27 mmol/L, representing an 80% reduction from baseline. Total cholesterol decreased by 59% on average, and LDL levels decreased by 69%. Statistically significant differences were observed in triglyceride and cholesterol levels before and after treatment. Four patients exhibited increased HDL levels posttreatment, while 1 patient showed a decrease. The average HDL/TC level was 21% higher after treatment. Conclusion: LA in HTG-AP effectively improves clinical symptoms, rapidly lowers lipid levels, and achieves good therapeutic outcomes. Plain Language Summary: Hypertriglyceridemia-associated pancreatitis is a condition where high levels of fats in the blood can lead to pancreas inflammation. The treatment goal is to quickly lower these fat levels. Lipid purification, a method to remove fats from the blood, has shown promise but lacks clear guidelines for its use. This study aimed to analyze the data of patients with this type of pancreatitis who underwent lipid purification to determine its effectiveness. Five patients diagnosed with acute lipogenic pancreatitis were included in the study. They received routine therapies and underwent lipid purification using a technique called DFPP. After a single treatment, significant improvements were observed in the patients' lipid levels. Triglyceride levels decreased by 80% on average, and total cholesterol decreased by 59%. Lipid purification effectively improved symptoms, reduced lipid levels. [ABSTRACT FROM AUTHOR]