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Although rare, hyperlipidemia (more specifically, hypertriglyceridemia) can lead to pancreatitis. The exact mechanism is unclear. However, it is thought to involved increased chylomicrons in the blood. Chylomicrons are very large triglyceride carrying molecules that are present in the highest concentrations 1-3 hours after eating. Typically, they are cleared from the blood within 8 hours. However, when triglyceride levels are very high (exceeding 1,000 mg/dL), chylomicrons are almost always present in the blood. Since they are very large, they may obstruct small vessels leading to ischemia and acidemia. This local damage can cause pancreatic lipases to degrade triglycerides within chylomicrons. The degradation of triglycerides to free fatty acids and glycerol in the pancreas leads to cytotoxic injury. Free fatty acids have a detergent effect and damage the pancreas. This leads to further local injury that increases inflammation, which produces pancreatitis.

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Q: How does hyperlipidemia causes pancreatitis?
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