Acute Pancreatitis as a Sequela of Hypertriglyceridemia Due to Hyperosmolar Hyperglycemic Syndrome

It is well known that hyperosmolar hyperglycemic state (HHS) can lead to hypertriglyceridemia (HTG), and that HTG can lead to acute pancreatitis. However, few case reports exist of these three conditions occurring simultaneously. In this case report, we describe a 49-year-old female with a past medical history of well-controlled hypertension who presented to the emergency department with abdominal pain and hematemesis after being found minimally responsive at home. Labs and imaging on admission were consistent with acute pancreatitis in the setting of severe HTG. She also had a significantly elevated glucose and serum osmolality consistent with HHS. We suggest the patient had HHS that led to an HTG severe enough to cause acute pancreatitis. These findings may provide insight into HHS as an important predisposing condition to acute pancreatitis.