Endocrine Abstracts

Introduction: Major hypertriglyceridemia is a rare pathology associated with severe acute complications. We report the case of a patient with major hypertriglyceridemia complicated by acute pancreatitis.

Observation: This is a 51-year-old patient with a history of hypertriglyceridemia on fenofibrate 160 mg per day and an attack of acute pancreatitis on chronic alcoholism. He consults for transfixing epigastric pain. The clinical examination found overweight (BMI at 29 kg/m²) and android obesity. The biological assessment shows hyperleukocytosis with neutrophils, a CRP at 304 mg/l, a hypertriglyceridemia at 15.55 g/l, a hypercholesterolemia at 10.20 g/l, serum with a chylous appearance. Abdominal CT confirmed stage D acute pancreatitis. Treatment was started urgently with intensive rehydration, suspension of food, basal insulin therapy under cover with 5% serum glucose and heparin therapy at a preventive dose associated with analgesics. The patient also received treatment with fibrates and statins. The evolution is favorable clinically and biologically with a drop in triglycerides.

Discussion and conclusion: Major hypertriglyceridaemia is exceptional. Their severity is linked to the high risk of acute pancreatitis requiring early management.