Pancreatitis, acute, lipemia

This disorder is usually expressed in childhood. In a review of 43 cases, 35 were manifested before the age of appears that those patients with low to absent LPL activity in all tissue present with symptoms of the disease at an early age (classic form), whereas those with deficiency in LPL activity in only one tissue become symptomatic later in life (variant forms). This disease is usually detected after recurrent episodes of severe abdominal pain and repeated attacks of pancreatitis. Eruptive xanthomas and lipemia reti-nalis are usually present when plasma triglyceride concentrations exceed 2000 and 4000mg/dL, respectively. The acuteness of the symptoms is directly proportional to the degree of hyperchylomicronemia. It is important to note that patients with this disorder do not appear to be predisposed to atherosclerotic disease. 

However, when transient lipemia occurs during the course of acute pancreatitis, as documented by Brunner (1935) and Marcus (1937), and abdominal episodes far precede hyperlipemia (Joel 1924), it appears proper to consider such hyperlipemia secondary to pancreatitis (Thannhauser 1950). This concept is supported by the animal experiments of Binet and Brocq (1929) and others. For further discussion of experimental aspects of the subject we refer to Schettler (1955, Handbuch pg. 724—725). 

Once the presence of fasting lipemia has been established, di-ffereyitiation between primary and secondary hyperlipemias can usually be made on the basis of presence or absence of clinical and laboratory findings characteristic of an underlying disease. Plasma lipid and lipoprotein patterns as determined by lipid analyses, ultracentrifugation and electrophoresis are not necessarily diagnostic since similar findings are present in EHL and hyperlipemia of diabetic ketoacidosis, acute pancreatitis, alcoholism, etc. (Schettler 1955, Lees and Fredrickson 1964, Jahnke 1965). 

Marcus, M. The pancreas and intermediate fat metabolism observations on disturbance of the fat metabolism with temporary lipemia in acute pancreatic disease. Fol. din. orient. (Tel-Aviv) 1, 127 (1937) cit. after Klatskin and Gordon (1952). 

PouLSEN, H. M. Familial lipemia. A new form of lipidosis showing increase in neutral fats combined with attacks of acute pancreatitis. Acta med. scand. 138, 413 (1950). 

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