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Hypertriglyceridaemia in pregnancy: an unexpected diagnosis and its management
A woman in her 30s with gestational diabetes presented at 36 weeks’ gestation with reduced fetal movements and diminishing insulin requirements. In view of her gestation, she was induced and incidentally found to have profound hyponatraemia. Further biochemical investigations confirmed severe hypert...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438015/ https://www.ncbi.nlm.nih.gov/pubmed/36038155 http://dx.doi.org/10.1136/bcr-2022-249000 |
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author | Barclay, Kathryn Koysombat, Kanyada Padmagirison, Radhika Kaplan, Felicity |
author_facet | Barclay, Kathryn Koysombat, Kanyada Padmagirison, Radhika Kaplan, Felicity |
author_sort | Barclay, Kathryn |
collection | PubMed |
description | A woman in her 30s with gestational diabetes presented at 36 weeks’ gestation with reduced fetal movements and diminishing insulin requirements. In view of her gestation, she was induced and incidentally found to have profound hyponatraemia. Further biochemical investigations confirmed severe hypertriglyceridaemia and hypercholesterolaemia. This raises the possibility of secondary causes such as familial dysbetalipoproteinemia and polygenetic hypertriglyceridaemia. She was successfully managed by aggressive dietary modification. This involved a supervised fast followed by a fat-free diet. A fenofibrate was proposed but declined due to our patient’s wish to breastfeed. Management required considerable input from the multidisciplinary team. Treatment options to consider are aggressive dietary restriction of fat or the addition of a cholesterol-lowering medication, such as a fibrate. In refractory cases, a supervised fast may be required or, in cases where complications have arisen, apheresis. The patient and her baby made a good recovery with no long-lasting health implications. |
format | Online Article Text |
id | pubmed-9438015 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-94380152022-09-14 Hypertriglyceridaemia in pregnancy: an unexpected diagnosis and its management Barclay, Kathryn Koysombat, Kanyada Padmagirison, Radhika Kaplan, Felicity BMJ Case Rep Case Reports: Rare disease A woman in her 30s with gestational diabetes presented at 36 weeks’ gestation with reduced fetal movements and diminishing insulin requirements. In view of her gestation, she was induced and incidentally found to have profound hyponatraemia. Further biochemical investigations confirmed severe hypertriglyceridaemia and hypercholesterolaemia. This raises the possibility of secondary causes such as familial dysbetalipoproteinemia and polygenetic hypertriglyceridaemia. She was successfully managed by aggressive dietary modification. This involved a supervised fast followed by a fat-free diet. A fenofibrate was proposed but declined due to our patient’s wish to breastfeed. Management required considerable input from the multidisciplinary team. Treatment options to consider are aggressive dietary restriction of fat or the addition of a cholesterol-lowering medication, such as a fibrate. In refractory cases, a supervised fast may be required or, in cases where complications have arisen, apheresis. The patient and her baby made a good recovery with no long-lasting health implications. BMJ Publishing Group 2022-08-29 /pmc/articles/PMC9438015/ /pubmed/36038155 http://dx.doi.org/10.1136/bcr-2022-249000 Text en © BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ. |
spellingShingle | Case Reports: Rare disease Barclay, Kathryn Koysombat, Kanyada Padmagirison, Radhika Kaplan, Felicity Hypertriglyceridaemia in pregnancy: an unexpected diagnosis and its management |
title | Hypertriglyceridaemia in pregnancy: an unexpected diagnosis and its management |
title_full | Hypertriglyceridaemia in pregnancy: an unexpected diagnosis and its management |
title_fullStr | Hypertriglyceridaemia in pregnancy: an unexpected diagnosis and its management |
title_full_unstemmed | Hypertriglyceridaemia in pregnancy: an unexpected diagnosis and its management |
title_short | Hypertriglyceridaemia in pregnancy: an unexpected diagnosis and its management |
title_sort | hypertriglyceridaemia in pregnancy: an unexpected diagnosis and its management |
topic | Case Reports: Rare disease |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438015/ https://www.ncbi.nlm.nih.gov/pubmed/36038155 http://dx.doi.org/10.1136/bcr-2022-249000 |
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