Severe hypertriglyceridemia in pregnancy
Abstract
CONTEXT: Pregnancy-related hypertriglyceridemia is rare, but it can be life threatening in some patients with genetic susceptibility. Complications can include acute pancreatitis, hyperviscosity syndrome, and possibly preeclampsia. We present a case of successful management of recurrent gestational chylomicronemia due to compound heterozygous mutations in the LPL gene. EVIDENCE ACQUISITION: To outline advances in clinical management of this condition, we searched English language publications in PubMed, EMBASE, and ISI Web of Science (search terms: pregnancy, pregnancy complications, pregnan*, hyperlipoproteinemia, hypertriglyceridemia, chylomicrons, chylomicronemia) and reference lists of relevant published articles from 2002 to 2011. We identified eight case reports. EVIDENCE SYNTHESIS: Interventions reported in those cases are reviewed including: 1) low-fat diet; 2) nutritional supplements; 3) oral prescription medications; 4) parenteral heparin; 5) insulin infusion in the context of hyperglycemia; and 6) therapeutic plasma exchange. CONCLUSIONS: Overall, our recommendations are to monitor for pregnancy-related hypertriglyceridemia in those with prepregnancy fasting triglyceride level greater than 4 mmol/liter and to institute therapy when triglyceride level increases to more than 10 mmol/liter. Therapy should include a multidisciplinary team to address dietary fat restriction, appropriate supplements, and possible medications when needed. Admission to hospital is recommended in severe cases. We conclude that complications are preventable with appropriate and timely intervention.
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Plasma TGs normally rise during pregnancy, especially during the third trimester.
“Plasma TGs normally rise during pregnancy, 45 especially during the third trimester.46”
From Familial chylomicronemia syndrome: Bringing to life dietary recommendations throughout the life span (2018) · cites this paper as [46]
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Self-citation
- Authors
- Goldberg, A. S., & Hegele, R. A.
- Affiliations
- Western University (CA)
- Corresponding author
- Hegele, Robert A.
- ORCID
- Hegele, Robert A.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2012-08
- Volume
- 97
- Issue
- 8
- Pages
- 2589-2596
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1981499442
- Cited by
- 187
- References
- 46
- Citations by year
- 2026: 11 · 2025: 16 · 2024: 7 · 2023: 6 · 2022: 17 · 2021: 12 · 2020: 9 · 2019: 12 · 2018: 8 · 2017: 59 · 2016: 5 · 2015: 10 · 2014: 6 · 2013: 5 · 2012: 2
- FWCI
- 4.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (79853_1, 79523_1, MOP13430)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Health Sciences › Medicine › Surgery › Lymphatic Disorders and Treatments
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- LPL gene mutations, lipoprotein lipase deficiency, acute pancreatitis, hyperviscosity syndrome, preeclampsia, low-fat diet, heparin, insulin infusion, plasma exchange
- MeSH terms
- Adult, Combined Modality Therapy, Female, Humans, Plasma Exchange, Pregnancy, Pregnancy Complications, Hypertriglyceridemia
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