title: Managing hypertriglyceridemia in children with systemic lupus erythematosus: Two sides of the same coin.
abstract: Hypertriglyceridemia is common in children with systemic lupus erythematosus (SLE). A retrospective analysis of the baseline clinical-pathological presentation and treatment outcome (status of lipid profiles) was performed in two children with SLE, who presented with extreme hypertriglyceridemia over a follow-up period of four weeks. The children were treated with prednisolone, mycophenolate mofetil (MMF), hydroxychloroquine and hypolipidemic agents, depending on their disease status. On serial follow-up, the first child showed a significantly raised serum triglyceride level after receiving one week of oral prednisolone therapy. Anti-lipoprotein-lipase (LPL) autoantibody was absent. Lipid profile levels of this child gradually improved after replacing oral prednisolone with another immunosuppressant, namely MMF. The second child presented with extreme hypertriglyceridemia with positive anti-LPL autoantibody. She responded to plasmapheresis followed by increasing the dose of immunosuppressant. So, extreme hypertriglyceridemia in children with SLE may be steroid induced or due to presence of anti-LPL auto antibody. Management should be individualized depending on the etiology.
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, NRS Medical College & Hospital, Kolkata, India. Electronic address: basuv3000@gmail.com.
authors.forename: Biswanath
authors.initials: B
authors.lastname: Basu
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, NRS Medical College & Hospital, Kolkata, India.
authors.forename: Binu George
authors.initials: BG
authors.lastname: Babu
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, NRS Medical College & Hospital, Kolkata, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Bhattacharyya
mesh_terms: D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D015228:Hypertriglyceridemia / Q000188:drug therapy* / Q000209:etiology; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy*; D009173:Mycophenolic Acid / Q000627:therapeutic use*; D011239:Prednisolone / Q000627:therapeutic use*
chemical_list: D000960:Hypolipidemic Agents; D007166:Immunosuppressive Agents; D006886:Hydroxychloroquine; D011239:Prednisolone; D009173:Mycophenolic Acid
keywords: Hipertrigliceridemia; Hypertriglyceridemia; Lipoprotein lipase; Lipoproteína lipasa; Lupus eritematoso sistémico; Systemic lupus erythematosus