# Severe Hypertriglyceridemia-Induced Pancreatitis Presenting as Diabetic Ketoacidosis in a Young Adult With Type 2 Diabetes Mellitus

## TL;DR

A young adult with type 2 diabetes presented with diabetic ketoacidosis and was found to have severe hypertriglyceridemia-induced pancreatitis, which improved rapidly with plasmapheresis.

## Contribution

This case highlights the rare but critical overlap between hypertriglyceridemia-induced pancreatitis and diabetic ketoacidosis, emphasizing the role of plasmapheresis in treatment.

## Key findings

- A 20-year-old male with type 2 diabetes presented with DKA and was diagnosed with HTGP.
- Urgent plasmapheresis led to rapid clinical improvement and a significant drop in triglyceride levels.
- The case emphasizes the importance of considering HTGP in DKA patients with abdominal pain.

## Abstract

Hypertriglyceridemia-induced pancreatitis (HTGP) is an uncommon but serious condition typically associated with markedly elevated triglyceride levels, often exceeding 1,000 mg/dL and more frequently seen above 2,000-3,000 mg/dL. Diabetic ketoacidosis (DKA), a common complication in patients with poorly controlled diabetes, may contribute to or be worsened by hypertriglyceridemia due to insulin deficiency and increased lipolysis. We report the case of a 20-year-old male with type 2 diabetes mellitus who presented with DKA and was subsequently diagnosed with HTGP. The patient experienced significant clinical improvement following urgent plasmapheresis, which resulted in a rapid decline in triglyceride levels. This case underscores the importance of considering hypertriglyceridemia as a potential underlying cause in patients with DKA and abdominal pain and highlights the therapeutic role of plasmapheresis in achieving metabolic stabilization.