Scully's medical problems in dentistry

Abstract

Around 75% of FH is undiagnosed, so screening for LDLR, APOB and PCSK9 genes may help. Familial hyperlipidemia is often associated with recurrent acute pancreatitis. Incidence proportions for associated pancreatitis are approximately 35% for familial type I, 15% for type IV, and 30% to 40% for type V.128 The type of pancreatitis is usually acute and recurrent, although pancreatic insufficiency has been reported with types I and V.370,371 The mechanism whereby high serum triglyceride levels lead to pancreatic injury is unknown, although the most popular and well-substantiated theory involves the intrapancreatic breakdown of excessive triglycerides by lipase and release of noxious free fatty acids.372 Although hypertriglyceridemia (typical-ly >500 mg/dL373) is associated with recurrent acute pancreatitis, the relationship between hypertryglyceridemia, or other hyperlipidemias, and chronic pancreatitis remains controversial. Conditions to consider include familial lipoprotein lipase deficiency374,375 and apolipoprotein C-II deficiency,376,377 both of which cause chronic hypertriglyceridemia and bouts of pancreatitis that segregate with the disease gene. Chronic pancreatitis was seen in an extended Dutch kindred of patients with