Severe L-asparaginase-induced Hypertriglyceridaemia Treated with Plasmapheresis

Silvano, José and Marques, Nidia and Tavares, Isabel and Ferreira, Ines (2021) Severe L-asparaginase-induced Hypertriglyceridaemia Treated with Plasmapheresis. European Journal of Case Reports in Internal Medicine, 8 (2). pp. 1-3. ISSN ISSN: 2284-2594

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L-asparaginase is used for the treatment of acute lymphoblastic leukaemia. Hypertriglyceridaemia is a side effect and associated with potentially fatal complications, including acute pancreatitis. Plasmapheresis may have a role in treatment when triglycerides are >2000 mg/dl.We report the case of a 39-year-old woman treated with L-asparaginase for acute lymphoblastic leukaemia, who developed severe hypertriglyceridaemia (6560 mg/dl) and acute pancreatitis. Intravenous insulin infusion was started, along with fenofibrate and atorvastatin administration, and platelet transfusion. Plasmapheresis was carried out leading to a frank decline in serum triglyceride levels (366 mg/dl), a decrease in pancreatic enzymes and clinical improvement.The diagnosis of pancreatitis secondary to L-asparaginase should lead to immediate drug withdrawal, and plasmapheresis should be considered when serum triglyceride values exceed 2000 mg/dl. In our case, there was a 95% triglyceride removal rate. This response illustrates the strong effectiveness of early treatment with plasmapheresis in severe and symptomatic hypertriglyceridaemia associated with L-asparaginase.

Item Type: Article
Uncontrolled Keywords: L-asparaginase, hypertriglyceridemia, pancreatitis, plasmapheresis
Subjects: 600 Tecnologia - Scienze applicate
600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici)
600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale)
Depositing User: Marina Spanti
Date Deposited: 20 Dec 2021 15:21
Last Modified: 20 Dec 2021 15:21

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