Objective: High triglyceride (TG) levels are associated with an increased risk for atherosclerotic cardiovascular disease (ASCVD) and pancreatitis. The objectives for this study were to evaluate for the coexistence of severe HTG and pancreatitis in two different geographic regions of Turkey and to identify rare variants that cause monogenic HTG in our country.Methods: In our study from 2014 to 2019, patients with severe HTG who presented to the endocrinology outpatient clinics with TG levels >500 mg/dL (5.7 mmol/L) were evaluated. The LPL, APOC2, APOA5, GPIHBP1, LMF1, and APOE genes were sequenced using next generation sequencing to screen for potentially pathogenic variants.Results: Potentially pathogenic variants were identified in 64 (47.1%) of 136 patients. Variants in LPL were seen in 42 (30.9%) cases, APOA5 variants in 10 (7.4%) cases, APOC2 variants in 5 (3.7%) cases, LMF1 variants in 5 (3.7%) cases, and APOE mutations in 2 (1.5%) cases. In the subgroup that experienced pancreatitis (n = 76, 56.3%), LPL variants were seen at higher frequency (P <0.001) than in the subgroup with no history of pancreatitis (n = 60, 43.7%).Patients who developed pancreatitis (56.3%) demonstrated a median TG of 2083 mg/dL (23.5 mmol/L), and patients without pancreatitis (43.7%) demonstrated a median TG of 1244.5 mg/dL (14.1 mmol/L) (P <0.001).
Conclusion:Accurate approach to HTG diagnosis is important for the prevention of pancreatitis and ASCVD. Evaluation of variants in primary HTG after excluding secondary causes may help provide a patient-centric precision treatment plan.
A thinner is an industrial solvent that is composed of some aromatic hydrocarbons. Acute or chronic intoxication is frequently seen among industrial workers who inhale solvent vapor and in teenager's abuse using thinner. Suicidal injection use of a thinner is very rare. An 18-year-old young boy presented to our department with pain and swelling in his left arm. His complaints had started three days after he attempted suicide with the injection of a paint thinner. High fever, extensive swelling, and local warming in the left arm from the shoulder to the over hand was observed on admission. His leukocyte count was 26820/mm 3 and CRP level was 194mg/L. Because his clinical picture mimicked severe soft tissue infection, antibiotic treatment was initiated. Abscess formation developed at the injection site on day eight, and surgical drainage was performed. Upon clinical and laboratory improvement, the patient was discharged on the 16th day of therapy. This case is presented here and highlights attempted suicide using a paint thinner injection.
A 48-year-old man was diagnosed Acute myeloid leukemia with FLT3 ITD positive and PML/RAR?- negative. Remission was
achieved after induction and consolidation chemotherapy. Allogeneic hematopoietic stem cell transplantation was performed
from his full matched sibling donor. He relapsed after 5 years and his bone marrow examination revealed PML/RAR?-
positive Acute promyelocytic leukemia. t(15:17) was positive and FLT-3 ITD was negative. Cytogenetic and molecular analysis
confirmed donor cell origin. Donor didn’t develop Acute promyelocytic leukemia.
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