ECE2024 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (383 abstracts)
Severe hypertriglyceridemia in type 2 diabetes with systemic lupus accompanied by acute pancreatitis
Hemmat el Haddad , Rokaya Abdel Aziz , Heba Moustafa , Heba Murad , Nehal Hamdy , Ahmed Fayed , Ihab Sameeh , Randa Salam , Samar Amin , Mona Youssry & Fatma Fayed
Cairo University, Internal medicine, endocrinology, Cairo, Egypt
Introduction: Severe HTG usually occurs in a patient with genetic predisposition encoding various apolipoproteins (APOE, APOA5, APOC2, APOB), lipoprotein lipase (LPL), exacerbated by secondary factors as diabetes, obesity, high alcohol intake
Case report: 35 yr old diabetic male presented with repeated vomiting with severe epigastric pain He had similar attack 1 year ago diagnosed as acute pancreatitis. 3 years ago he was diagnosed SLE with antiphospholipid on prednisone 5 mg, mycophenolate mofetil 1.5 mg, hydroxychloroquine 400 mg, warfarin 4 mg Upon admission, he was alert, Pulse: 140 beat/minute Blood pressure: 80/40 Respiratory rate: 32/minute. Temperature: 38ºC, tenderness over the epigastrium. Laboratory investigations; RBS 500 mg/dl, A1C: 14.7 %, ABG (PH: 7.38 HCO3: 26 Mm/l SaO2 98.0%) HB;12.4 g/dl, TLC: 24/ul PLT:77,000/uL/CRP: 265 mg/dl/Chol: 425 mg/dl, LDL: 257 mg/dl, HDL: 25 mg/dl, TG: 1547 mg/dl Amylase: 1323U/l, Lipase: 2278U/l/Na: 141mEq/l, K: 3.8 mEq/l, Urea: 100 mg/dl Creatinine: 2.1 mg/dl., ALT: 73 IU/l, AST: 73IU/l, Bil T: 4.5 mg/dl, Albumin: 4 g/dl Abdominopelvic sonar showed: Pancreatic edema with pancreatic cyst (9×7 cms). CT abdomen: Enlarged pancreatic head, perihepatic& peri pancreatic free fluid collection for pigtail insertion. Culture and sensitivity of collected fluid: E.coli, candida. The patient started, antifungal, fluids and insulin, NPO Icosapent Ethyl 2 gm and fenofibrate 320 mg, cholesterol dropped to 102 mg/dl, triglycerides to 293 mg/dl discharged on fibrates with life style modification
Conclusions: Patients with severe hypertricylcerideamia require fast and effective lowering of TG levels in order to reverse the lipotoxic effect
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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