title: Tamoxifen-induced hypertriglyceridemia causing acute pancreatitis.
abstract: Tamoxifen has both antagonistic and agonistic tissue-specific actions. It can have a paradoxical estrogenic effect on lipid metabolism resulting in elevated triglyceride and chylomicron levels. This can cause life-threatening complications like acute pancreatitis. To our knowledge, very few cases of tamoxifen-induced pancreatitis have been reported in the literature. We report a case of severe hypertriglyceridemia and acute pancreatitis following tamoxifen use. A 50-year-old diabetic lady was on tamoxifen (20mg/day) hormonal therapy for breast cancer. Within 3 months of starting therapy, she developed hypertriglyceridemia and acute pancreatitis. Laboratory values include: Serum amylase 778 IU/L, total cholesterol 785 mg/dL, triglycerides 4568 mg/dL and high-density lipoproteins (HDL) 12 mg/dL. Tamoxifen was substituted with letrozole and atorvastatin started. There was a prompt reversal of the adverse effects. Effects on lipid profile must be considered while initiating tamoxifen in predisposed individuals as the consequences are life threatening.
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Hemant Kumar
authors.initials: HK
authors.lastname: Singh
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Mahendranath S
authors.initials: MS
authors.lastname: Prasad
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Arun K
authors.initials: AK
authors.lastname: Kandasamy
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Kadambari
authors.initials: K
authors.lastname: Dharanipragada
keywords: Breast; carcinoma; hypertriglyceridemia; pancreatitis; tamoxifen