title: Hypertriglyceridemia: Is there a role for prophylactic apheresis? A case report.
abstract: Severe hypertriglyceridemia has been consistently associated with an increased risk of cardiovascular disease and other complications, namely acute pancreatitis. We report a case of a 64 year-old woman with hypertrophic cardiomyopathy and metabolic syndrome with triglyceride level of 3260 mg/dL. Plasma exchange was performed with simultaneous medical treatment to achieve a rapid and effective lowering of triglycerides in order to prevent clinical complications. After three plasmapheresis sessions a marked reduction in triglyceride and total cholesterol levels was observed. Several cases have shown the importance of plasmapheresis in the treatment of acute pancreatitis. We intend to demonstrate the applicability of this technique as primary prophylaxis in the presence of extremely high serum triglyceridemia levels. Resumo A hipertrigliceridemia grave tem sido associada de forma consistente ao aumento do risco cardiovascular e a outras complicações, nomeadamente, pancreatite aguda. Descrevemos um caso de uma mulher de 64 anos, com miocardiopatia hipertrófica e síndrome metabólica com valor sérico de triglicerídeos de 3260 mg/dL. Foi efectuada plasmaferese e optimizado o tratamento médico para alcançar uma redução rápida e efectiva dos níveis dos triglicerídeos, prevenindo complicações clínicas. Após três sessões de plasmaferese, verificou-se uma redução marcada dos triglicerídeos e do colesterol total. Existem alguns casos descritos na literatura demonstrado a importância da plasmaferese no tratamento da pancreatite aguda em contexto de hipertrigliceridemia grave. Os autores pretendem com este caso demonstrar a aplicabilidade desta técnica em contexto de prevenção primária em doentes com níveis de triglicerídeos extremamente aumentados.
authors.affiliation: Cardiology Department, Santa Maria University Hospital, Centro Hospitalar de Lisboa Norte, CCUL, University of Lisbon, Portugal.
authors.forename: Ana Rita
authors.initials: AR
authors.lastname: Francisco
authors.affiliation: Cardiology Department, Santa Maria University Hospital, Centro Hospitalar de Lisboa Norte, CCUL, University of Lisbon, Portugal.
authors.forename: Inês
authors.initials: I
authors.lastname: Gonçalves
authors.affiliation: Cardiology Department, Santa Maria University Hospital, Centro Hospitalar de Lisboa Norte, CCUL, University of Lisbon, Portugal.
authors.forename: Fátima
authors.initials: F
authors.lastname: Veiga
authors.affiliation: Cardiology Department, Santa Maria University Hospital, Centro Hospitalar de Lisboa Norte, CCUL, University of Lisbon, Portugal.
authors.forename: Mónica Mendes
authors.initials: MM
authors.lastname: Pedro
authors.affiliation: Cardiology Department, Santa Maria University Hospital, Centro Hospitalar de Lisboa Norte, CCUL, University of Lisbon, Portugal.
authors.forename: Fausto J
authors.initials: FJ
authors.lastname: Pinto
authors.affiliation: Cardiology Department, Santa Maria University Hospital, Centro Hospitalar de Lisboa Norte, CCUL, University of Lisbon, Portugal.
authors.forename: Dulce
authors.initials: D
authors.lastname: Brito
mesh_terms: D001781:Blood Component Removal; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications*; D008875:Middle Aged; D011322:Primary Prevention