CASE REPORTS   Free access

Minerva Anestesiologica 2011 October;77(10):1018-21

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

Hyperlipidemic acute pancreatitis: a possible role of antiretroviral therapy with entecavir

Durval A., Zamidei L., Bettocchi D., Luzzio M. G., Consales G. ✉

Anesthesia and Intensive Care Unit, Misericordia e Dolce Hospital, Prato, Italy

In most cases clinical profile of acute hyperlipidemic pancreatitis is a preexisting lipoprotein abnormality associated to second risk factors such as alcohol abuse, diabetes mellitus or medications that can induce hypertrygliceridemia. We report a case of a young male affected by chronic hepatitis B virus infection admitted to Emergency Department due to acute abdominal pain, vomiting and fever. The patient was in antiretroviral treatment with entecavir; moreover he was affected by diabetes mellitus and he presented a past history of alcohol abuse. Laboratory tests demonstrated hyperglycemia, severe metabolic acidosis and hypertriglyceridemia, whereas abdominal computed tomography scan revealed peripancreatic edema: hyperlipidemic pancreatitits was supposed and the patient was admitted to the intensive care unit. Considering its possible role in the pathogenesis of pancreatitis, entecavir was interrupted and total of 3 sections of plasmapheresis were performed, allowing clinical resolution and prevention of pancreatic damage. The possible pathogenetic role of entecavir is discussed.