INS and alkaline phosphatase measurement: It shouldbe noted that apheresis was delayed in use, in this case, having been initiated 3weeks after the onset of AP.21 True efficacy of plasmapheresis is unknown as there are no randomizedcontrolled trials; therefore, definitive conclusions on the efficacy of apheresis inreducing AP severity cannot be made.22 Furthermore, due to its lack of availability at times, risks, and expense,insulin can be used as an alternative and potentially safer method of treatment.There remains a paucity of established guidelines for HTG-induced AP management inthe acute setting.