Treatment of Severe Hypertriglyceridemia During Pregnancy With High Doses of Omega-3 Fatty Acid and Plasmapheresis

Nguyen, Nguyen T; Nath, Priti; Vinh, Q.; Shakir, Mohamed K M; Hoang, Thanh D.

doi:10.1016/j.aace.2021.01.006

Cited by 12 publications

(7 citation statements)

References 22 publications

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“…FFP as fluid replacement successfully reduced lipid levels without complications and the symptoms of patients in the acute phase of the disease (8). This is because FFP may provide circulating TG hydrolysis by reducing inflammatory cytokines and replacing the deficiency of lipoprotein lipase or apolipoprotein (9). Finally, in this case, we recommend having close monitoring throughout the time the patient receives the infusion of insulin and FFP.…”

Section: Discussionmentioning

confidence: 94%

A Case of Hypertriglyceridemia in a Child 12 Years Old with Diabetic Ketoacidosis

Katebi

2023

J Compr Ped

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Introduction: Hypertriglyceridemia (HTG) and diabetic ketoacidosis (DKA) are complications of uncontrolled diabetes that may result in significant mortality or morbidity. Hypertriglyceridemia is a rare complication in children, and we report a case of hypertriglyceridemia in a child 12 years old with Diabetic Ketoacidosis. Case Presentation: We report the case of a 12-year-old patient who was referred to our center with polydipsia, polyuria, lethargy, and weakness. On admission, serum glucose was 300 mg/dL, hemoglobin A1c level was 10.7%, plasma triglyceride (TG) was very high, 13520 mg/dL, and cholesterol was 980 mg/dL. He had DKA with hypertriglyceridemia and acute pancreatitis. Conclusions: Insulin and fresh frozen plasma (FFP) injection is a safe, effective therapy for hypertriglyceridemia in DKA and rapidly lowers dangerously high triglyceride levels and prevents untoward complications.

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Section: Discussionmentioning

confidence: 94%

A Case of Hypertriglyceridemia in a Child 12 Years Old with Diabetic Ketoacidosis

Katebi

2023

J Compr Ped

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“…[6] The capillary endothelium is normally rich in ARA, suggesting that angiogenesis would be enhanced in the presence of ample ARA and inhibited when ARA is limiting. [13] EPA/DHA doses higher than 20 g/d have been used on a sustained basis (months to years) in humans for the treatment of traumatic brain injury, [14] 12 g/d to 15 g/d in hypertriglyceridemia [15] or hypertensive patients, [16] and in at least one pregnant woman who gave birth successfully, [17] and all doses were well tolerated. Enhanced bleeding times might be expected based on observations in individuals with high circulating EPA levels, though a recent metaanalysis showed mild effects up to 4 g/d.…”

Section: Discussionmentioning

confidence: 99%

High dose ω3 eicosapentaenoic acid and docosahexaenoic acid block, whereas ω6 arachidonic acid accelerates,MYCN-driven tumorigenesisin vivo

Patel,

Li,

Benhamou

et al. 2024

Preprint

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Neuroblastoma (NB) is a genetically diverse, highly metastatic pediatric cancer that accounts for an estimated 8% of childhood cancer incidence but is responsible for 15% of childhood cancer deaths. High-risk and relapsed cases have less than 50% and near 5% survival, respectively. The current standard of care is highly genotoxic, resulting in life-long health issues and an increased risk of new cancer incidence. Effective and less toxic approaches to neuroblastoma remain elusive. We show here that ω3 and ω6 highly unsaturated fatty acids (HUFA) have differential effects on tumor formation in a syngeneic model of neuroblastoma. We observe that 20 gram/d doses of ω3 DHA and EPA have a robust antitumor effect, wherein DHA and high-dose EPA completely abrogate tumor formation. In contrast, ω6 arachidonic acid (ARA) has the opposite effect, driving higher tumor penetrance and shorter latency. When used together, ARA and EPA treatment results in a reduced tumor burden analogous to the control group, indicating that EPA may directly oppose the mechanism of ARA-mediated tumor formation. ROS-resistant deuterated DHA (D-DHA), which has deuterium atoms in place of ordinary1H (protium) in the oxidatively labilebisallylic positions, also completely abrogated tumor formation, strongly suggesting that the mechanism of action is not through oxidation as might have been expected. Interestingly, despite high levels of fatty acid delivery, very little tissue accumulation was observed. These results suggest that high doses of ω3 HUFA DHA and EPA may represent a viable, low-toxicity avenue for neuroblastoma therapy.

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“…It should be noted that dyslipidemia during pregnancy should be carefully assessed not only for its acute complications but also to determine the long-term disease risk and risk of death of the fetus. Previously, the application of Beite drugs, heparin, and plasma exchange was reported to rapidly reduce blood lipids in pregnant women ( 28 , 29 ). However, few studies have addressed the management of HTG during pregnancy through medical nutrition therapy ( 30 , 31 ).…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary diagnosis and treatment of severe acute pancreatitis associated with hypertriglyceridemia in pregnancy: a case report

Li¹,

Wang²,

Li³

et al. 2022

Ann Transl Med

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Background Hypertriglyceridemia (HTG) is an important cause of acute pancreatitis (AP) in pregnant women. Due to the variable clinical features of acute pancreatitis, it is difficult to make a differential diagnosis when abdominal pain occurs in late pregnancy. Severe HTG induced acute pancreatitis during pregnancy is rare, but may be a fatal threat to both mothers and fetuses during the peripartum period, and can increase maternal and fetal mortality. If emotional disorder combined, difficulty of treatment increased. So, multidisciplinary diagnosis combination of psychiatric treatment could improve the diagnosis rate and cure rate of acute pancreatitis during pregnancy. Case Description We present the case of a 27-year-old Chinese woman in her first pregnancy, who was admitted to the hospital in the planned delivery period, but then developed progressive abdominal pain and whose biochemistry parameters were high enough to underwent a cesarean section as a result of AP a few hours after admission. The patient developed organ failure after a successful labor, which rapidly evolved to multi-organ failure, accompanied by depressive symptoms. Afterwards She appeared such as agitated, uneasy, and sad, and did not comply with the treatment, according to the classification of symptoms and course of disease, postpartum depression (PPD) was highly suspected. The patient benefited from multidisciplinary treatments that combined and integrated traditional Chinese medicine (TCM) with Western medicine therapies. The patient was discharged 35 days after her admission. Conclusions This case highlights the importance of monitoring and managing excess dyslipidemia during pregnancy. A proactive strategy should be encouraged in the management of the patients with high risk of pancreatitis to improve the outcomes of patients. Our case report elucidates the possible long-term effects of HTG and reminds us of the need for long-term management of those affected.

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Treatment of Severe Hypertriglyceridemia During Pregnancy With High Doses of Omega-3 Fatty Acid and Plasmapheresis

Cited by 12 publications

References 22 publications

A Case of Hypertriglyceridemia in a Child 12 Years Old with Diabetic Ketoacidosis

A Case of Hypertriglyceridemia in a Child 12 Years Old with Diabetic Ketoacidosis

High dose ω3 eicosapentaenoic acid and docosahexaenoic acid block, whereas ω6 arachidonic acid accelerates,MYCN-driven tumorigenesisin vivo

Multidisciplinary diagnosis and treatment of severe acute pancreatitis associated with hypertriglyceridemia in pregnancy: a case report

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