Therapeutic Plasma Exchange in Patients With Severe Hypertriglyceridemia: A Multicenter Study
2009; Wiley; Volume: 33; Issue: 12 Linguagem: Inglês
10.1111/j.1525-1594.2009.00810.x
ISSN1525-1594
AutoresClaudia Stefanutti, S. Di Giacomo, A. Vivenzio, Giancarlo Labbadia, Fabio Mazza, Giovanna D’Alessandri, Giampaolo Russi, Giustina De Silvestro, Piero Marson,
Tópico(s)Pancreatic function and diabetes
ResumoAbstract 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 ≤ 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.
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