Severe hypertriglyceridemia with a history of treatment failure.
Background A 53-year-old man with a history of hypertension and gout was referred to our clinic for severe hypertriglyceridemia, diagnosed 3 years previously. He was asymptomatic and had no history of abdominal pain, pancreatitis or diabetes, but consumed six cans of beer per night. Over the previous 2 years, he had been treated unsuccessfully with multiple medications; during this period his fasting triglycerides ranged from 5.41 mM to 55.04 mM (479 to 4,871 mg/dl). Investigations Physical examination including fundoscopy, medication review, and laboratory tests.Diagnosis Severe hypertriglyceridemia due to a genetic combined hyperlipidemia, exacerbated by persistent excessive alcohol intake and metabolic syndrome. Management Cessation of alcohol intake, initiation of a fat-restricted diet, and fibrate therapy, with close follow-up. Once serum triglycerides were controlled, attention was turned to lowering LDL-cholesterol concentration according to The National Cholesterol Education Program, Adult Treatment Panel III guidelines.
Capell
Warren H
WH
Division of Endocrinology, Metabolism, and Diabetes at the University of Colorado at Denver and Health Sciences Center, CO, USA. warren.capell@uchsc.edu
Eckel
Robert H
RH
D000428:Alcohol Drinking / Q000009:adverse effects; D018752:Diet, Fat-Restricted; D006801:Humans; D015228:Hypertriglyceridemia / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D013695:Temperance; D017211:Treatment Failure
D000960:Hypolipidemic Agents