The clinical characteristic of biliary-hyperlipidemic etiologically complex type of acute pancreatitis: a retrospective study from a tertiary center in China
- PMID: 33629316
- DOI: 10.26355/eurrev_202102_24854
The clinical characteristic of biliary-hyperlipidemic etiologically complex type of acute pancreatitis: a retrospective study from a tertiary center in China
Abstract
Objective: Biliary and hyperlipidemic acute pancreatitis (AP) has become the second most common AP in China. Currently, AP is exclusively diagnosed as biliary or hyperlipidemic AP. However, as suggested by some reports, biliary and hyperlipidemic AP might coexist in a single patient. Moreover, acute lipotoxicity was shown to regulate the severity of biliary AP in the mouse model. Thus, whether these two etiologies coexist in AP patients and potentially worsen the clinical course remains unclear. To elucidate the clinical feature of a new complex type of acute pancreatitis with both biliary and hyperlipidemic etiologies.
Patients and methods: This retrospective study included AP patients who were admitted into our department within 7 days after the onset of the disease. 267 AP patients were enrolled in this study and were classified as BAP (biliary acute pancreatitis, n=153), HLAP (hyperlipidemic acute pancreatitis, n=65) and BHAP (biliary-hyperlipidemic acute pancreatitis, n=49). All the enrolled patients met the classification criteria of biliary etiology, hyperlipidemic etiology, and both etiologies, respectively. BHAP was compared with BAP and HLAP in terms of general information, inflammatory biomarkers, organ dysfunction, disease severity and clinical outcomes.
Results: BHAP (41 vs. 53) patients were younger than BAP patients. Serum procalcitonin of BHAP patients was higher than BAP and HLAP patients. Serum CRP of BHAP patients was higher than BAP patients. BHAP patients had the highest diagnosis rate of severe acute pancreatitis (SAP) (46.9% vs. 17.6% or 21.5%) compared to BAP and HLAP. Prevalences of persistent respiratory, acute renal, and circulatory failure were highest in BHAP patients (44.9%, 28.6%, 12.2%, respectively). Requirements for mechanical ventilation, renal replacement therapy and vasoactive agents were also highest in BHAP patients (36.7%, 34.7%, 12.2%, respectively). Hospital stay was longer in BHAP patients (33 days) compared with BAP patients (24 days).
Conclusions: Patients with both biliary and hyperlipidemic etiologies suffer from more severe clinical course of the disease and have worse prognosis than single-etiology BAP or HLAP patients in the early stage of AP (within 7 days). It should be recognized as a new etiological type named biliary-hyperlipidemic acute pancreatitis (BHAP).
Similar articles
-
Ferroptosis exacerbates hyperlipidemic acute pancreatitis by enhancing lipid peroxidation and modulating the immune microenvironment.Cell Death Discov. 2024 May 21;10(1):242. doi: 10.1038/s41420-024-02007-1. Cell Death Discov. 2024. PMID: 38773098 Free PMC article. Review.
-
The clinical characteristic of alcohol-hyperlipidemia etiologically complex type of acute pancreatitis.Eur Rev Med Pharmacol Sci. 2022 Oct;26(19):7212-7218. doi: 10.26355/eurrev_202210_29913. Eur Rev Med Pharmacol Sci. 2022. PMID: 36263531 Review.
-
Serum levels of thyroid hormones and thyroid stimulating hormone in patients with biliogenic and hyperlipidaemic acute pancreatitis: Difference and value in predicting disease severity.J Int Med Res. 2016 Apr;44(2):267-77. doi: 10.1177/0300060515618052. Epub 2016 Jan 25. J Int Med Res. 2016. PMID: 26811409 Free PMC article.
-
Comparison of Existing Clinical Scoring Systems in Predicting Severity and Prognoses of Hyperlipidemic Acute Pancreatitis in Chinese Patients: A Retrospective Study.Medicine (Baltimore). 2015 Jun;94(23):e957. doi: 10.1097/MD.0000000000000957. Medicine (Baltimore). 2015. PMID: 26061329 Free PMC article.
-
Incidence and clinical features of hyperlipidemic acute pancreatitis from Guangdong, China: a retrospective multicenter study.Pancreas. 2014 May;43(4):548-52. doi: 10.1097/MPA.0000000000000069. Pancreas. 2014. PMID: 24717803
Cited by
-
Effect of early antibiotic treatment strategy on prognosis of acute pancreatitis.BMC Gastroenterol. 2023 Dec 9;23(1):431. doi: 10.1186/s12876-023-03070-1. BMC Gastroenterol. 2023. PMID: 38066411 Free PMC article.
-
Computed tomography characteristics of acute pancreatitis based on different etiologies at different onset times: a retrospective cross-sectional study.Quant Imaging Med Surg. 2022 Sep;12(9):4448-4461. doi: 10.21037/qims-21-1231. Quant Imaging Med Surg. 2022. PMID: 36060601 Free PMC article.
-
Patients-associated compound etiology may have more severe acute pancreatitis: a retrospective cohort study.Quant Imaging Med Surg. 2022 Aug;12(8):4109-4119. doi: 10.21037/qims-21-1157. Quant Imaging Med Surg. 2022. PMID: 35919042 Free PMC article.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous