One obvious explanation is that both HTG and increased level of chylomicrons (CM) lead to increase the plasma viscosity, which leads to ischaemia in pancreatic tissue and organ inflammation.7, 8 Germline mutations in LPL gene cause an extremely rare autosomal recessive familial lipoprotein lipase deficiency (LPLD) manifested with severe HTG and chylomicronaemia with recurrent AP.8, 9 According to the aetiology, HTG is classified into two types, primary and secondary.9 In addition, primary HTG is usually caused by germline mutations of lipoprotein lipase (LPL) gene. Here, LPL is linked to alkaline phosphatase measurement.