Bloodletting to Treat Severe Hypertriglyceridemia

Letters16 July 2019Bloodletting to Treat Severe HypertriglyceridemiaPhilipp Koehler, MD*, Paul J. Bröckelmann, MD*, Michael Hallek, MD, and Matthias Kochanek, MDPhilipp Koehler, MD*University Hospital of Cologne, Cologne, Germany (P.K., P.J.B., M.H., M.K.), Paul J. Bröckelmann, MD*University Hospital of Cologne, Cologne, Germany (P.K., P.J.B., M.H., M.K.), Michael Hallek, MDUniversity Hospital of Cologne, Cologne, Germany (P.K., P.J.B., M.H., M.K.), and Matthias Kochanek, MDUniversity Hospital of Cologne, Cologne, Germany (P.K., P.J.B., M.H., M.K.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0706 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Plasmapheresis is necessary to treat some cases of severe hypertriglyceridemia.Objective: To describe successful treatment of severe hypertriglyceridemia in a patient for whom plasmapheresis was not possible.Case Report: A 39-year-old man came to the emergency department with nausea, vomiting, malaise, headache, and slowly deteriorating alertness. He had diabetes mellitus of an unknown type and a history of cholelithiasis and cholecystitis. He had been prescribed daily doses of sitagliptin, 100 mg; dapagliflozin, 10 mg; and pantoprazole, 40 mg, but he was taking these drugs intermittently. Two days earlier, he saw an outpatient physician for nausea, vomiting, unwanted weight loss, ...References1. Lek M, Karczewski KJ, Minikel EV, Samocha KE, Banks E, Fennell T, et al; Exome Aggregation Consortium. Analysis of protein-coding genetic variation in 60,706 humans. Nature. 2016;536:285-91. [PMID: 27535533] doi:10.1038/nature19057 CrossrefMedlineGoogle Scholar2. Ewald N, Kloer HU. Treatment options for severe hypertriglyceridemia (SHTG): the role of apheresis. Clin Res Cardiol Suppl. 2012;7:31-5. [PMID: 22528130] CrossrefMedlineGoogle Scholar3. Erondu N, Desai M, Ways K, Meininger G. Diabetic ketoacidosis and related events in the canagliflozin type 2 diabetes clinical program. Diabetes Care. 2015;38:1680-6. [PMID: 26203064] doi:10.2337/dc15-1251 CrossrefMedlineGoogle Scholar4. Peters AL, Buschur EO, Buse JB, Cohan P, Diner JC, Hirsch IB. Euglycemic diabetic ketoacidosis: a potential complication of treatment with sodium-glucose cotransporter 2 inhibition. Diabetes Care. 2015;38:1687-93. [PMID: 26078479] doi:10.2337/dc15-0843 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University Hospital of Cologne, Cologne, Germany (P.K., P.J.B., M.H., M.K.)Note: The patient gave written informed consent for his case report to appear in publications in any medium worldwide.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L18-0706.This article was published at Annals.org on 26 February 2019.* Drs. Koehler and Bröckelmann contributed equally to this report. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 16 July 2019Volume 171, Issue 2Page: 142-143KeywordsCholesterolFatty acidsGlucoseHeparinHypercholesterolemiaInsulinIntensive care unitsNauseaOutpatientsVomiting ePublished: 26 February 2019 Issue Published: 16 July 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...