Treatment of Severe Hypertriglyceridemia During Pregnancy With High Doses of Omega-3 Fatty Acid and Plasmapheresis

Nguyen T. Nguyen, MD; Priti V. Nath, MD; Vinh Q. Mai, DO; Mohamed K.M. Shakir, MD; Thanh D. Hoang, DO

AACE Clinical Case Reports (May 2021)

Treatment of Severe Hypertriglyceridemia During Pregnancy With High Doses of Omega-3 Fatty Acid and Plasmapheresis

Nguyen T. Nguyen, MD,
Priti V. Nath, MD,
Vinh Q. Mai, DO,
Mohamed K.M. Shakir, MD,
Thanh D. Hoang, DO

Affiliations

Nguyen T. Nguyen, MD: Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA; Division of Endocrinology, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Priti V. Nath, MD: Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA; Division of Endocrinology, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Vinh Q. Mai, DO: Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA; Division of Endocrinology, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Mohamed K.M. Shakir, MD: Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA; Division of Endocrinology, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Thanh D. Hoang, DO: Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA; Division of Endocrinology, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; Address correspondence and reprint requests to Dr. Thanh D. Hoang, DO, Division of Endocrinology, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, Maryland 20889.

Journal volume & issue: Vol. 7, no. 3
pp. 211 – 215

Abstract

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Objective: Severe hypertriglyceridemia carries increased health risks, including the development of pancreatitis. The objective of this study was to report on management of 2 cases with severe gestational hypertriglyceridemia. Cases: In case 1, a 33-year-old pregnant woman presented with serum triglyceride level of 14 000 mg/dL after discontinuing hypolipidemic medications. She was treated with Lovaza 12 g/day, and serum triglyceride remained near normal at level of less than 800 mg mg/dL until delivery. In case 2, a 28-year-old patient (29th week gestation) presented with acute pancreatitis and triglycerides >4000 mg/dL. She was treated with Gemfibrozil, Lovaza, insulin infusion, subcutaneous heparin, and escalated to plasmapheresis. She successfully delivered a baby at the week of 36th and her triglyceride level was 304 mg/dL after that. Discussion: Case 1 was treated with high-dose Lovaza and case 2 was treated with plasmapheresis successfully. Triglyceride levels were reduced to less than 500 mg/dL until delivery of healthy babies in both cases. Conclusion: Omega-3 fatty acids and plasmapheresis may be effective and safe to treat pregnant women with severe hypertriglyceridemia and pancreatitis.

Published in AACE Clinical Case Reports

ISSN: 2376-0605 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://www.journals.elsevier.com/aace-clinical-case-reports

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