Lipid apheresis in the management of severe hypertriglyceridaemia in an adolescent girl with global developmental delay

Hypertriglyceridaemia-induced acute pancreatitis (HTG-AP) remains one of the common metabolic causes of acute pancreatitis in the paediatric population and the third most common cause after alcohol and gallstones in the adult population. We report a case of an early adolescent girl with global developmental delay and moderate cognitive impairment of unknown aetiology who presented with recurrent acute pancreatitis and uncompensated hypovolaemic shock. She was found to have serum triglyceride level of 7877 mg/dL (reference range<150 mg/dL) and hyperglycaemia with ketosis (no prior history of diabetes mellitus) that was successfully treated with lipid apheresis. This sometimes is an early modality for treatment in adults; however, it remains a last resort in children, used only for severe cases. A brief literature review on severe HTG-AP and its management is also provided.