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Gestational hyperlipidemia and acute pancreatitis with underlying partial lipoprotein lipase deficiency and apolipoprotein E3/E2 genotype

The Korean Journal of Internal Medicine 2013년 28권 5호 p.609 ~ p.613

한동희(Han Dong-Hee) - Hallym University College of Medicine Department of Internal Medicine
모인호(Moh In-Ho) - Hallym University College of Medicine Department of Internal Medicine
김두만(Kim Doo-Man) - Hallym University College of Medicine Department of Internal Medicine
임성희(Ihm Sung-Hee) - Hallym University College of Medicine Department of Internal Medicine
최문기(Choi Moon-Gi) - Hallym University College of Medicine Department of Internal Medicine
유형준(Yoo Hyung-Joon) - Hallym University College of Medicine Department of Internal Medicine
홍은경(Hong Eun-Gyoung) - Hallym University College of Medicine Department of Internal Medicine

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.