[Oral contraceptive-induced pancreatitis in the hyperchylomicronemia syndrome].
A now 24-year-old woman was found at the age of 2 years to have an hyperchylomicronaemia syndrome due to lipoprotein lipase deficiency: the triglyceride level was then 6000 mg/dl. But in subsequent years it had been reduced to between 550 and 2600 mg/dl by dieting. There were no xanthomas or abdominal symptoms during those years. When aged 20 years she was put on oral contraceptives (one-phase preparation: 0.03 mg ethinylestradiol and 0.075 gestodene). Six months later she had the first attack of severe necrotizing pancreatitis; three more attacks followed in the subsequent 6 months. All four attacks occurred during the drug-free period of the menstrual cycle. The relationship with contraceptive intake was not established until the fourth attack. The last acute pancreatitis (lipase 3283 U/l amylase 595 U/l, triglyceride 2400 mg/dl, WBC count 13,899/microliters; ultrasonography revealed fluid swelling and necrotic areas, especially around the splenic hilus) regressed within 5 days and has not recurred for 3 years after the patient stopped taking oral contraceptives. On a diet the triglyceride level has been around 880 mg/dl.
Schaefer
J R
JR
Abteilung für Endokrinologie und Stoffwechsel, Universität Marburg.
Steinmetz
A
A
Dugi
K
K
Ehlenz
K
K
von Wichert
P
P
Kaffarnik
H
H
D000208:Acute Disease; D000328:Adult; D003276:Contraceptives, Oral / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008072:Hyperlipoproteinemia Type I / Q000150:complications* / Q000178:diet therapy; D009336:Necrosis; D009652:Norpregnenes / Q000009:adverse effects*; D010195:Pancreatitis / Q000139:chemically induced* / Q000473:pathology; D014280:Triglycerides / Q000097:blood
D003276:Contraceptives, Oral; D009652:Norpregnenes; D014280:Triglycerides; C033273:Gestodene; D004997:Ethinyl Estradiol
Durch orale Kontrazeptiva induzierte Pankreatitis bei Hyperchylomikronämie-Syndrom.