title: Gestational hyperlipidemia and acute pancreatitis with underlying partial lipoprotein lipase deficiency and apolipoprotein E3/E2 genotype.
abstract: We report the case of a patient who experienced extreme recurrent gestational hyperlipidemia. She was diagnosed with partial lipoprotein lipase (LPL) deficiency but without an associated LPL gene mutation in the presence of the apolipoprotein E3/2 genotype. This is the first reported case of extreme gestational hyperlipidemia with a partial LPL deficiency in the absence of an LPL gene mutation and the apolipoprotein E 3/2 genotype. She was managed with strict dietary control and medicated with omega-3 acid ethyl esters. A patient with extreme hyperlipidemia that is limited to the gestational period should be considered partially LPL-deficient. Extreme instances of hyperlipidemia increase the risk of acute pancreatitis, and the effect of parturition on declining plasma lipid levels can be immediate and dramatic. Therefore, decisions regarding the timing and route of delivery with extreme gestational hyperlipidemia are critical and should be made carefully.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Hallym University College of Medicine, Hwaseong, Korea.
authors.forename: Dong Hee
authors.initials: DH
authors.lastname: Han
authors.forename: In Ho
authors.initials: IH
authors.lastname: Moh
authors.forename: Doo-Man
authors.initials: DM
authors.lastname: Kim
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Ihm
authors.forename: Moon-Gi
authors.initials: MG
authors.lastname: Choi
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yoo
authors.forename: Eun-Gyoung
authors.initials: EG
authors.lastname: Hong
mesh_terms: D000208:Acute Disease; D000328:Adult; D053329:Apolipoprotein E2 / Q000235:genetics*; D053318:Apolipoprotein E3 / Q000235:genetics*; D015415:Biomarkers / Q000097:blood; D003131:Combined Modality Therapy; D018752:Diet, Fat-Restricted; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy; D020022:Genetic Predisposition to Disease; D006801:Humans; D008072:Hyperlipoproteinemia Type I / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000235:genetics* / Q000628:therapy; D008055:Lipids / Q000097:blood; D008071:Lipoprotein Lipase / Q000235:genetics; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D010289:Parenteral Nutrition, Total; D010641:Phenotype; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000235:genetics* / Q000628:therapy; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D053329:Apolipoprotein E2; D053318:Apolipoprotein E3; D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D008055:Lipids; C548261:LPL protein, human; D008071:Lipoprotein Lipase
keywords: Apolipoproteins E; Hyperlipidemias; Lipoprotein lipase; Pregnancy