Gestational hyperlipidemia and acute pancreatitis with underlying partial lipoprotein lipase deficiency and apolipoprotein E3/E2 genotype
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We report the case of a patient who experienced extreme recurrent gestational hyperlipidemia. She was diagnosed with partial lipoprotein lipase (LPL) deficiency but without an associated LPL gene mutation in the presence of the apolipoprotein E3/2 genotype. This is the first reported case of extreme gestational hyperlipidemia with a partial LPL deficiency in the absence of an LPL gene mutation and the apolipoprotein E 3/2 genotype. She was managed with strict dietary control and medicated with omega-3 acid ethyl esters. A patient with extreme hyperlipidemia that is limited to the gestational period should be considered partially LPL-deficient. Extreme instances of hyperlipidemia increase the risk of acute pancreatitis, and the effect of parturition on declining plasma lipid levels can be immediate and dramatic. Therefore, decisions regarding the timing and route of delivery with extreme gestational hyperlipidemia are critical and should be made carefully.
Abstract
We report the case of a patient who experienced extreme recurrent gestational hyperlipidemia. She was diagnosed with partial lipoprotein lipase (LPL) deficiency but without an associated LPL gene mutation in the presence of the apolipoprotein E3/2 genotype. This is the first reported case of extreme gestational hyperlipidemia with a partial LPL deficiency in the absence of an LPL gene mutation and the apolipoprotein E 3/2 genotype. She was managed with strict dietary control and medicated with omega-3 acid ethyl esters. A patient with extreme hyperlipidemia that is limited to the gestational period should be considered partially LPL-deficient. Extreme instances of hyperlipidemia increase the risk of acute pancreatitis, and the effect of parturition on declining plasma lipid levels can be immediate and dramatic. Therefore, decisions regarding the timing and route of delivery with extreme gestational hyperlipidemia are critical and should be made carefully.
참고문헌 (10)
- Leaf DA., "Chylomicronemia and the chylomicronemia syndrome: a practical approach to management", Am J Med, 121, pp.10~12 (2008)
- Basaran A., "Pregnancy-induced hyperlipoproteinemia: review of the literature", Reprod Sci, 16, pp.431~437 (2009)
- Weisgraber KH, "Mahley RW. Abnormal lipoprotein receptor-binding activity of the human E apoprotein due to cysteine-arginine interchange at a single site", J Biol Chem, 257, pp.2518~2521 (1982)
- Gregg RE, "Type III hyperlipoproteinemia: defective metabolism of an abnormal apolipoprotein E", Science, 211, pp.584~586 (1981)
- Dallongeville J, "Modulation of plasma triglyceride levels by apoE phenotype: a meta-analysis", J Lipid Res, 33, pp.447~454 (1992)
- Weintraub MS, "Dietary fat clearance in normal subjects is regulated by genetic variation in apolipoprotein E", J Clin Invest, 80, pp.1571~1577 (1987)
- Ma Y, "High frequency of mutations in the human lipoprotein lipase gene in pregnancy- induced chylomicronemia: possible association with apolipoprotein E2 isoform", J Lipid Res, 35, pp.1066~1075 (1994)
- Eskandar O, "Severe, gestational, non-familial, non-genetic hypertriglyceridemia", J Obstet Gynaecol Res, 33, pp.186~189 (2007)
- Kobayashi J, "Lipoprotein lipase mass and activity in severe hypertriglyceridemia", Clin Chim acta, 216, pp.113~123 (1993)
- Hosokawa A, "Use of lipid-lowering agents (statins) during pregnancy", Can Fam Physician, 49, pp.747~749 (2003)