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Endocrine Abstracts (2024) 99 EP165 | DOI: 10.1530/endoabs.99.EP165

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

Volume 99

26th European Congress of Endocrinology

Stockholm, Sweden
11 May 2024 - 14 May 2024

European Society of Endocrinology 

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