title: Hypertriglyceridemia as a possible cause of coma: a case report.
abstract: BACKGROUND
  Many studies suggest that elevated triglyceride levels are associated with increased long-term risk of stroke, including transient ischemic attacks. In addition, elevated triglyceride levels independently contribute to plasma viscosity and decreased blood flow. However, no consensus has been reached regarding the significance of hypertriglyceridemia as an independent risk factor for ischemic stroke.
  
  
  METHODS
  We report the case of a patient admitted to our hospital for sudden onset of coma. Laboratory test results revealed he had high blood glucose (28.2mmol/L), high glycated hemoglobin (11.4 percent), considerably high serum triglyceride levels (171.5mmol/L; type V hyperlipoproteinemia), and high plasma viscosity (1.90mPa/s) with normal β-hydroxybutyric acid levels. His triglyceride levels decreased after administering intravenous fluids. Our patient's consciousness level improved gradually over three days. All serum lipid levels decreased seven days after admission.
  
  
  CONCLUSIONS
  The findings in our patient's case are likely explained by triglyceride-mediated hyperviscosity causing a transient ischemic attack. In the present report we suggest that when several tests do not reveal the cause of stroke-like symptoms, measurement of plasma viscosity may be informative.
authors.affiliation: Department of Emergency and Critical Care Medicine, Ohta Nishinouchi Hospital, 2-5-20 Nishinouchi, Koriyama, Fukushima, 963-8558, Japan. inokuchir-icu@h.u-tokyo.ac.jp.
authors.forename: Ryota
authors.initials: R
authors.lastname: Inokuchi
authors.forename: Akinori
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Ryuta
authors.initials: R
authors.lastname: Azihara
authors.forename: Hajime
authors.initials: H
authors.lastname: Sato
authors.forename: Yoshibumi
authors.initials: Y
authors.lastname: Kumada
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Megumi
authors.initials: M
authors.lastname: Okada
authors.forename: Tokiya
authors.initials: T
authors.lastname: Ishida
authors.forename: Kensuke
authors.initials: K
authors.lastname: Nakamura
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakajima
authors.forename: Naoki
authors.initials: N
authors.lastname: Yahagi
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Shinohara