PDF(Pubmed)
Abstract：
There are increasing reports of the effects of COVID-19 on the pancreas. Pancreatitis, as a result of hypertriglyceridemia, has also been reported. Hypothesized mechanisms include hemophagocytic lymphohistiocytosis (HLH) syndrome and acquired lipoprotein lipase (LPL) inhibitors. We present a 51-year-old female patient who presented with nausea, vomiting, and epigastric abdominal pain radiating to the back. On examination, she had generalized abdominal tenderness without guarding or rebound tenderness. Our workup revealed elevated lipase of 1150 units/L, triglycerides (TG) of 11340 mg/dL, and mild pancreatitis on an abdominal computed tomography (CT) scan. On day 2, she developed a new oxygen requirement and tested positive for COVID-19. She was treated with fluids and opiates for pancreatitis, plasmapheresis, and an insulin infusion to treat her hypertriglyceridemia. She was treated with remdesivir for an acute COVID-19 infection. Triglycerides decreased to <500 mg/dL with treatment, and she was discharged home on oral lipid-lowering agents. By discussing this case, we aim to shed light on the association between COVID-19 and hypertriglyceridemia, which can further lead to life-threatening complications such as acute pancreatitis. Further studies are needed to identify the exact mechanisms, preventive measures, and long-term effects of COVID-19 on triglycerides and the pancreas.
摘要：
关于COVID-19对胰腺影响的报道越来越多。胰腺炎,由于高甘油三酯血症，也有报道。假设机制包括噬血细胞淋巴组织细胞增多症（HLH）综合征和获得性脂蛋白脂酶（LPL）抑制剂。我们介绍了一名51岁的女性患者，她出现了恶心，呕吐,上腹部腹痛放射到背部。在检查中，她有全身腹部压痛，没有保护或反弹压痛。我们的检查显示脂肪酶升高了1150单位/升，甘油三酯（TG）为11340mg/dL，腹部计算机断层扫描（CT）扫描显示轻度胰腺炎。在第2天，她开发了一种新的需氧量，并检测出COVID-19呈阳性。她因胰腺炎接受了液体和阿片类药物治疗，血浆置换,注射胰岛素来治疗她的高甘油三酯血症.她因急性COVID-19感染接受了雷米西韦治疗。甘油三酯降低到<500毫克/分升治疗，她因口服降脂药出院回家。通过讨论这个案子,我们的目标是阐明COVID-19与高甘油三酯血症之间的关系，这可能进一步导致危及生命的并发症，如急性胰腺炎。需要进一步的研究来确定确切的机制，预防措施,以及COVID-19对甘油三酯和胰腺的长期影响。
