Abstract
Background: To outline the underlying pathogenesis and treatment of hypertriglyceride induced pancreatitis and its rarity in the setting of hyperglycemia
Case Report: This subject presented with the clinical picture of acute pancreatitis confirmed by lipase and CT findings. Her initial Triglyceride level was 2178 and did not have hyperglycemia or underlying diabetes. She was treated successfully with a fibrate derivative at 600 mg twice daily. She was told to follow up with her primary care physician for investigation of familial hyperlipoproteinemia.
Conclusions: In the setting of acute pancreatitis from hypertriglyceridemia without hyperglycemia, and with inciting event Fredrickson class IV hyperliporpoteinemia is the likely underlying pathology. As was seen in our subject, there is a logical diagnostic approach based upon glucose level and inciting event.

Keywords: acute pancreatitis, hypertrigliceridemia, familial hypercholesterolemia