Endocrine Abstracts

Introduction: The disturbance of the lipid balance during pregnancy is common. Nevertheless, major hypertriglyceridemia during pregnancy is rare and can not be attributed to pregnancy.

Methods: We report the case of a pregnant woman hospitalized at the national nutrition institute of Tunis (departement A) for the management of a major hypertriglyceridemia.

Results: This is a 28-year-old female patient with ovarian stimulation-induced pregnancy, followed for gestational diabetes mellitus with insulin therapy,hospitalized at 24 weeks of amenorrhea for management of major hypertriglyceridemia (16 mmol/L). She has no other pathological history, neither personal nor familial,particularly dyslipidemia. Acute pancreatitis was eliminated. She had a preconceptional weight of 80kg, a weight gain of 0.6 kg/month. The average HbA1C was 6.7%. Other lipid parameters, hepatic, renal and thyroid status were normal. The patient was put on a hypo-lipid diet with an adjustment of insulin doses, with a favorable evolution and a decrease of triglyceride to 4.6 mmol/L.

Conclusion: Induction of pregnancy seems to be the most likely etiology of this hypertriglyceridemia, related to the stimulation, by high levels of estrogen, of hepatic synthesis of very low density lipoprotein (VLDL). Thus, such rare causes of hypertriglyceridemia should not be ignored, given the risks involved, including acute pancreatitis, which may affect maternal and fetal prognosis.