C-reactive Protein Apheresis: A Novel Treatment Approach in Acute Necrotising Pancreatitis.

Acute necrotizing pancreatitis is a severe condition associating with high morbidity and mortality. In most cases, supportive therapy is the only available therapeutic option. Herein, we report a case of a 29-year-old male who presented with severe acute necrotizing pancreatitis caused by hypertriglyceridemia, who consequently developed acute respiratory distress syndrome and multi-organ failure. We used an off-label C-reactive protein apheresis to target the sterile inflammatory reactions additional to optimal supportive therapy with invasive ventilation, prone positioning, continuous veno-venous hemodialysis using a CytoSorb™ particle filter, antibiotics, vasopressors, and fluids. After 18 days of intensive care treatment and 11 days of normal care treatment, the patient could be discharged alive.