Severe Hypertriglyceridemia Associated With Everolimus Treatment After Heart Transplantation

Phillip Lo, MD, MMed; Katherine Kearney, MBBS, MMed, FRACP; Christopher A. Muir, MBBS, FRACP; Ning Song, MBBS, FRACP; John A. Eisman, MBBS, PhD, FRACP; Peter S. Macdonald, MBBS, MD, PhD, FRACP

AACE Clinical Case Reports (Sep 2020)

Severe Hypertriglyceridemia Associated With Everolimus Treatment After Heart Transplantation

Phillip Lo, MD, MMed,
Katherine Kearney, MBBS, MMed, FRACP,
Christopher A. Muir, MBBS, FRACP,
Ning Song, MBBS, FRACP,
John A. Eisman, MBBS, PhD, FRACP,
Peter S. Macdonald, MBBS, MD, PhD, FRACP

Affiliations

Phillip Lo, MD, MMed: Address correspondence to Dr. Phillip Lo, St. Vincent’s Hospital, 390 Victoria Street, Darlinghurst, New South Wales, 2010, Australia.; From the Heart Failure and Transplant Unit, St. Vincent’s Hospital, Sydney, Australia; the Faculty of Medicine, University of New South Wales, Sydney, Australia
Katherine Kearney, MBBS, MMed, FRACP: From the Heart Failure and Transplant Unit, St. Vincent’s Hospital, Sydney, Australia; the Faculty of Medicine, University of New South Wales, Sydney, Australia
Christopher A. Muir, MBBS, FRACP: the Faculty of Medicine, University of New South Wales, Sydney, Australia; the Department of Endocrinology, St. Vincent’s Hospital, Sydney, Australia
Ning Song, MBBS, FRACP: From the Heart Failure and Transplant Unit, St. Vincent’s Hospital, Sydney, Australia; the Faculty of Medicine, University of New South Wales, Sydney, Australia
John A. Eisman, MBBS, PhD, FRACP: the Faculty of Medicine, University of New South Wales, Sydney, Australia; the Department of Endocrinology, St. Vincent’s Hospital, Sydney, Australia; the Garvan Institute of Medical Research, Sydney, Australia; School of Medicine Sydney, University of Notre Dame, Sydney, Australia
Peter S. Macdonald, MBBS, MD, PhD, FRACP: From the Heart Failure and Transplant Unit, St. Vincent’s Hospital, Sydney, Australia; the Faculty of Medicine, University of New South Wales, Sydney, Australia; the Victor Chang Cardiac Research Institute, Sydney, Australia.

Journal volume & issue: Vol. 6, no. 5
pp. e269 – e272

Abstract

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ABSTRACT: Objective: Everolimus, a mammalian target-ofrapamycin (mTOR) inhibitor, is increasingly used post-transplantation due to favorable effects on renal function and malignancy risk when compared to other immunosuppressive treatments such as calcineurin inhibitors. However, it can confer adverse effects such as dyslipidemia, which is not underpinned by any long-term screening and management of dyslipidemia in heart transplant recipients treated with everolimus. Methods: We report a case of severe hypertriglyceridemia which developed after commencement of everolimus in a heart transplant recipient with a background of Dunnigan-type familial partial lipodystrophy. Results: The patient is a 36-year-old woman who underwent heart transplantation for dilated cardiomyopathy. About 11 weeks following commencement of everolimus as part of her antirejection medication regime, serum triglyceride level concentration peaked at 5,093 mg/dL (normal, 0.0 to 177.2 mg/dL). There were no clinical complications with triglycerides at this elevated level and it improved substantially following cessation of everolimus and initiation of a high dose intravenous insulin-dextrose infusion. Conclusion: This case highlights dyslipidemia as a potential complication of everolimus treatment and that appropriate screening is important as lipid lowering medication can effectively control levels and minimize adverse outcomes. Abbreviations: FPLD familial partial lipodystrophy LPL lipoprotein lipase MMF mycophenolate mofetil mTOR mammalian target-of-rapamycin

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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