Triglyceride Levels Greater Than 10,000 mg/dL in a 49-Year-Old Female without Evidence of Pancreatitis

Toor, Anika; Toor, Amit; Khalighi, Koroush; Krishnamurthy, Mahesh

doi:10.1155/2019/6273196

Cited by 10 publications

(9 citation statements)

References 16 publications

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“…31 , 32 , 33 Hypertriglyceridemia is one of the most common lipid abnormalities and has been known to be associated with other metabolic derangements. 34 Patients with overdose of certain opiates like cocaine and codeine usually present with muscle pain and tenderness. Laboratory tests detect an increase of creatinine and urea, potassium, phosphorus, and creatine kinase levels.…”

Section: Discussionmentioning

confidence: 99%

Alterations in the biochemical indices in Wistar rats exposed to an overdose of codeine and dextromethorphan

Kayode

Oridota

2021

Journal of Taibah University Medical Sciences

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Objective This study investigates the impact of repeated oral exposure to two cough syrups containing codeine and dextromethorphan (DXM) on male Wistar rats. Methods We divided 35 rats into seven groups of five rats each. Group A was given 0.5 mL of distilled water, Groups B, C, and D were given 0.1, 0.2 and 0.4 mL/kg body weight ( b. w ) of cough syrup containing codeine (CSC), respectively, and Groups E, F, and G were administered 0.1, 0.2 and 0.4 mL/kg b. w of cough syrup containing DXM, respectively. The treatment was continued for 28 days. The rats were euthanised under mild diethyl ether anaesthesia. The kidney, liver, and blood of the rats were examined for further analyses. Results Significant ( p < 0.05) alterations were observed in the liver function tests: ALT, AST, ALP, albumin, and total bilirubin. All doses of CSC and DXM significantly increased the ALT levels ( p < 0.05). Furthermore, similar significant alterations were observed for the kidney function parameters such as creatinine, urea, and uric acid (p < 0.05). All doses of DXM caused significant elevations in the levels of urea ( p < 0.05). The histopathological evaluations also showed slight changes in the architecture of the liver, kidney, and brain tissues. Conclusion The findings of this study suggest that overdose of these cough syrups may predispose the consumer to hepatic and renal injuries.

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Section: Discussionmentioning

confidence: 99%

Alterations in the biochemical indices in Wistar rats exposed to an overdose of codeine and dextromethorphan

Kayode

Oridota

2021

Journal of Taibah University Medical Sciences

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“…Patients in this study and in previous case reports were mostly young adults or children (Tables 1 and 4). 23,24 Interestingly, some patients with serum triglyceride levels higher than 10 000 mg/dL did not develop AP, suggesting that very severe hypertriglyceridemia is not sufficient to cause 25,26 . Other factors, such as obesity and diabetes, may also play a role in the pathogenesis of AP; however, this is still controversial.…”

Section: Discussionmentioning

confidence: 99%

“…23,24 Interestingly, some patients with serum triglyceride levels higher than 10 000 mg/dL did not develop AP, suggesting that very severe hypertriglyceridemia is not sufficient to cause. 25,26 Other factors, such as obesity and diabetes, may also play a role in the pathogenesis of AP; however, this is still controversial. DKA is a common complication of diabetes that is caused by insulin deficiency.…”

Section: Discussionmentioning

confidence: 99%

Whole exome sequencing identifies three novel gene mutations in patients with the triad of diabetic ketoacidosis, hypertriglyceridemia, and acute pancreatitis

Huang

et al. 2020

Journal of Diabetes

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Background This study aimed to analyze the genetics and treatments of the patients with the triad of diabetic ketoacidosis (DKA), hypertriglyceridemia, and acute pancreatitis (AP). Methods We conducted a retrospective study of six patients with the triad of AP, hypertriglyceridemia, and DKA at our hospital. All patients underwent plasmapheresis as part of their treatment. The clinical characteristics of the patients were obtained from the hospital information system and analyzed. Whole exome sequencing was performed using samples of one patient (case 6) and his family members. Results The average triglyceride level before plasmapheresis was 3282.17 ± 2975.43 mg/dL (range: 1646‐9332 mg/dL). The triglyceride levels dropped by approximately 80% after plasmapheresis. None of the patients developed complications related from plasmapheresis. During follow‐up, patients 5 and 6 developed recurrent pancreatitis for several times and showed the formation of pancreatic pseudocysts. We identified three novel heterozygous missense mutations in the family of patient 6, including c.12614C > T (p.Pro4205Leu) in APOB, c.160G > C (p.Glu54Gln) in CILP2, and c.1199C > A (p.Ala400Glu) in PEPD. Conclusions Three novel heterozygous missense mutations, including c.12614C > T (p.Pro4205Leu) in APOB, c.160G > C (p.Glu54Gln) in CILP2, and c.1199C > A (p.Ala400Glu) in PEPD were first identified in a patient with the triad of DKA, hypertriglyceridemia, and AP. The combination of plasmapheresis, hydration, and insulin therapy may have the greatest clinical benefits for these patients.

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“…This value is extremely high, considering that over 2000 mg/dL of triglyceride is a high risk for pancreatitis. Furthermore, to the best of our knowledge, this triglyceride level in this subject is the highest in medical literature [4].…”

Section: Discussionmentioning

confidence: 99%

Severe hypertriglyceridemia in a subject with disturbed life style and poor glycemic control without recurrence of acute pancreatitis: a case report

et al. 2019

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Background Hypertriglyceridemia is often observed as the result of lipid abnormality and frequently associated with other lipid and metabolic disorders. Aggravation of hypertriglyceridemia is caused by various conditions. However, severe hypertriglyceridemia is usually induced by an addition of some secondary clinical conditions such as uncontrolled type 2 diabetes mellitus (T2DM) and obesity with insulin resistance. Case presentation A 40-year-old man with 4-year history of dyslipidemia and T2DM visited after his interruption of therapy for about 1.5 years. His past history was acute pancreatitis. His life style was markedly disturbed, and he had a lot of risk factors for hypertriglyceridemia. Surprisingly, his serum triglyceride level was as high as 16,900 mg/dL. His aggravation and remission of hypertriglyceridemia were closely associated with the alteration of RLP-cholesterol levels in dyslipidemia and glycoalbumin and ketone body levels in T2DM. Conclusion We report very severe hypertriglyceridemia, which seemed to be caused by markedly disturbed life style and poorly controlled T2DM. Total therapy with diet and drug for each disease is very important for the improvement of very severe hypertriglyceridemia. This case report suggests that very severe hypertriglyceridemia alone does not necessarily bring out acute pancreatitis, although it is very important to check pancreatitis markers in such a situation.

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Triglyceride Levels Greater Than 10,000 mg/dL in a 49-Year-Old Female without Evidence of Pancreatitis

Cited by 10 publications

References 16 publications

Alterations in the biochemical indices in Wistar rats exposed to an overdose of codeine and dextromethorphan

Alterations in the biochemical indices in Wistar rats exposed to an overdose of codeine and dextromethorphan

Whole exome sequencing identifies three novel gene mutations in patients with the triad of diabetic ketoacidosis, hypertriglyceridemia, and acute pancreatitis

Severe hypertriglyceridemia in a subject with disturbed life style and poor glycemic control without recurrence of acute pancreatitis: a case report

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