2021 Volume 54 Issue 7 Pages 381-386
A 35‒year‒old male developed epigastric pain from the day before admission. Since the pain tended to worsen, he visited our emergency outpatient department. Abdominal CT showed peripancreatic fat stranding and he was hospitalized for acute pancreatitis. On admission, his Japanese pancreatitis prognosis criteria score was 0, and his acute pancreatitis grade on computed tomography was 1. However, his serum triglyceride (TG) level was very high (11,374 mg/dL), and he also had acute kidney injury (Cre 1.66 mg/dL). Overall, we judged that the risk of deterioration of his acute pancreatitis was high, and performed double filtration plasmapheresis (DFPP) for 2 days to remove TG in addition to general treatments for acute pancreatitis. These treatments reduced the serum TG level rapidly and the severity of the pancreatitis. It has been reported that plasmapheresis rapidly lowers serum TG levels in patient with acute pancreatitis with hypertriglyceridemia. As its disadvantages including infections associated with mass transfusion, electrolyte abnormalities, and cost problems have been mentioned, by substituting DFPP with albumin solution replacement, it is possible to improve the pathological condition while avoiding these disadvantages.
