Severe hypertriglyceridaemia: a North Queensland experience

Thuzar, Moe, O'Neill, Connor, Shenoy, Vasant, Malabu, Usman, and Sangla, Kunwarjit (2012) Severe hypertriglyceridaemia: a North Queensland experience. In: Annals of the Australasian College of Tropical Medicine (13) p. 39. From: Townsville Health Research Week, 8-12 October 2012, Townsville, QLD, Australia.

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Abstract

Background / Aims: Hypertriglyceridaemia (HTG) is a component of the metabolic syndrome and therefore very commonly seen in association with type 2 diabetes mellitus. Severe HTG can lead to acute pancreatitis and is more likely to be triggered when serum triglyceride (TG) level exceed 10mmol/L. There is a paucity of clear treatment guidelines for this presentation.

Methods: We reviewed 5 cases of severe HTG, 4 of whom presented with pancreatitis to the Townsville Hospital from 2010-mid 2012. The management and clinical course of these cases and available literature will be reviewed.

Results: All were male, overweight type 2 diabetic patients with age range 39-48 years. Four patients were Caucasians and one was a Torres Strait Islander (TSI). The serum TG level at time of presentation was around 100 mmol/L in all cases. Lipid electrophoresis revealed Frederickson type III hyperlipidaemia in 2 cases, type V in 2 cases. The four subjects were homozygous for apolipoprotein E3. Family history of hyperlipidaemia was negative except in one patient. Patients were managed with variable treatment modalities that included a combination of nil per oral (NPO), insulin, heparin, and lipid lowering medications. Serum triglyceride level in the first 24 hours decreased more rapidly in those patients who were managed with NPO and IV insulin compared to those who were not. Treatment was uncomplicated in all except one patient who subsequently developed a pancreatic pseudocyst.

Conclusion: Combination of NPO and IV insulin seems to be an important treatment strategy in acute management of severe hypertriglyceridaemia. L arger studies are needed to confirm our finding.

Item ID: 28795
Item Type: Conference Item (Abstract / Summary)
ISSN: 1448-4706
Date Deposited: 08 Sep 2013 23:39
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110306 Endocrinology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes @ 100%
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