Beyond Gallstones and Alcohol: Unveiling Hypertriglyceridemia as the Cause of Pancreatitis

Hypertriglyceridemia is a less frequent yet clinically significant cause of acute pancreatitis, accounting for approximately 4-10% of cases, and is often overlooked when routine laboratory analysis is hindered by lipemia-related analytical interference. We describe two cases of severe hypertriglyceridemia-induced pancreatitis presenting with acute abdominal pain and markedly elevated triglyceride levels. The first case involved polygenic hypertriglyceridemia triggered by undiagnosed diabetes. The second case represented secondary, alcohol-related hypertriglyceridemia. In both cases, lipemia-related laboratory interference complicated the initial evaluation, but prompt recognition and treatment with intravenous insulin led to rapid clinical and biochemical improvement. These cases highlight the need for early consideration of hypertriglyceridemia in pancreatitis of unclear etiology, awareness of laboratory artifacts, and prompt triglyceride-lowering therapy to prevent complications.