Management of Severe Hypertriglyceridemia Induced Pancreatitis in Children – A Case Report

INTRODUCTION: Hypertriglyceridemia (HTG) is an uncommon but potentially severe cause of acute pancreatitis (AP) in children. Severe HTG may require urgent interventions such as plasma exchange (PEX), and data on pediatric HTG-induced AP and its management is limited. CASE PRESENTATION: 15-year-old girl with maturity-onset diabetes of the young type 3 (MODY-3), metabolic syndrome, and obesity, who developed HTG-induced AP shortly after starting oral contraception. Laboratory tests revealed severe hypertriglyceridemia (13102 mg/dL) and elevated lipase (280 U/L). Initial management included the standardized measures of AP. Due to persistently high HTG, infusion of unfractionated heparin and insulin, as well as a session of PEX were administered, resulting in rapid decrease of triglycerides and clinical improvement. DISCUSSION/CONCLUSION: This case highlights the synergistic effect of genetic, metabolic and hormonal factors in pediatric HTG-AP and underscores the importance of early recognition and aggressive management. Targeted interventions, including PEX, may be justified in high-risk patients to prevent complications and achieve rapid recovery.