Journal of Clinical Images and Medical Case Reports

ISSN 2766-7820
Case Report - Open Access, Volume 2

Severe hypertriglycerdemia in pregnancy

Krithika Muralidhara*; Shashank Dhareshwar

Department of Nephrology, St Johns Medical College Hospital, Bangalore, India.

*Corresponding Author : Krithika Muralidhara
Assistant professor, Department of Nephrology, St Johns Medical College Hospital, Bangalore, India.
Email: [email protected]

Received : Feb 22, 2021

Accepted : Mar 26, 2021

Published : Mar 28, 2021

Archived : www.jcimcr.org

Copyright : © Muralidhara K (2021).

Clinical image description

R31 year old female presented with abdominal pain and respiratory distress in the third trimester of her second pregnancy. Her blood workup revealed a lipemic sample (Figure 1A) due to markedly elevated serum triglycerides of 8178 mg/dl (Glycerol Phosphate Oxidase method). Total cholesterol and Low Density Lipoprotein were elevated at 1701 mg/dl and 788 mg/dl respectively. There was no family history of lipid disorders. Diagnosis was consistent with gestational hypertriglyceridemia with acute pancreatitis (Serum Amylase-50 U/L, Serum Lipase- 96 U/L), though genetic tests to rule out pre-existing primary hypertriglyceridemia was not feasible. In view of the life threatening condition, she was initiated on Insulin-Dextrose infusion and offered one session of Plasma Exchange. Figures 1B and 1C depict membrane plasma separation with the obtained effluent as lipemic plasma. Her serum triglycerides showed a declining trend and was discharged in good health (serum triglycerides at discharge-651 mg/dl).

Citation: Muralidhara K, Dhareshwar S. Severe hypertriglycerdemia in pregnancy. J Clin Images Med Case Rep. 2021; 2(2): 1034.
Figure 1
Figure 1: Figure A. Lipemic blood sample during routine workup. Figure B. Membrane Plasma Exchange showing lipemic plasma in plasma filter. Figure C. Lipemic plasma collected as effluent after plasma exchange.