Lipolytic activity of post-heparin plasma in hyperglyceridemia

Fredrickson, Donald S.; Ono, Katsuto; Davis, Louis L.

doi:10.1016/s0022-2275(20)40361-x

Cited by 328 publications

(6 citation statements)

References 23 publications

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“…Previous reports have shown OCTs to induce pancreatitis in patients with covert familial hyperlipidemias that were uncovered once the OCT was started. [2][3][4][5] Several factors contribute to estrogen-induced hypertriglyceridemia and the subsequent development of acute pancreatitis. Estrogen has been known to increase triglyceride levels by decreasing hepatic lipase activity.…”

Section: Discussionmentioning

confidence: 99%

“…Familial hyperlipidemia syndromes such as lipoprotein lipase deficiency and familial hypertriglyceridemia are examples of the latter, whereas the use of estrogen-containing oral contraceptives (OCTs) is an example of the former. Often, OCTs unmask a familial hyperlipidemia syndrome that had not been discovered before the patient began taking the OCT. [2][3][4][5] We present what appears to be the first reported case of severe hypertriglyceridemic acute pancreatitis in a young woman taking norethindrone acetate/ethinyl estradiol (Estrostep; Warner Chilcott, Rockaway, New Jersey), an estrophasic OCT agent. This relatively new OCT medication was not shown to significantly elevate serum triglyceride levels in clinical trials.…”

Section: Introductionmentioning

confidence: 99%

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Hypertriglyceridemic Pancreatitis Caused by the Oral Contraceptive Agent Estrostep

Abraham

Mitchell

Simsovits

et al. 2014

J Intensive Care Med

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Norethindrone acetate/ethinyl estradiol (Estrostep; Warner Chilcott, Rockaway, New Jersey) is an "estrophasic" type of oral contraceptive, which combines a continuous low progestin dose with a gradually increasing estrogen dose. In clinical trials, this medication failed to produce clinically significant changes in serum lipid levels. We report a case of severe hypertriglyceridemia-induced acute pancreatitis in a 24-year-old woman caused by Estrostep, occurring nearly 10 years after she began using the drug. The patient was admitted to the medical intensive care unit (ICU) for aggressive volume resuscitation and management of severe electrolyte abnormalities. Laboratory studies obtained on admission indicated severe hypertriglyceridemia (2,200 mg/dL), hyponatremia (120 mEq/L), and hypocalcemia (0.78 mmol/L). Amylase and lipase levels were also elevated (193 and 200 U/L, respectively). Ranson score calculated after 48 hours of admission was 4, and her Acute Physiology and Chronic Health Evaluation (APACHE) IV score was 35. Treatment included an insulin infusion, ω-3 fatty acid esters, and gemfibrozil. The insulin infusion reduced serum triglyceride levels by 50% after 1 day of treatment and to 355 mg/dL by day 7 of her ICU course. We believe that this is the first reported case of severe, acute hypertriglyceridemia-induced pancreatitis caused by this medication.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hypertriglyceridemic Pancreatitis Caused by the Oral Contraceptive Agent Estrostep

Abraham

Mitchell

Simsovits

et al. 2014

J Intensive Care Med

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“…Der Chylomikronenund VLDL-Katabolismus wird im wesentlichen durch die Lipoproteinlipase vermittelt. Da bei der Typ-V-Hyperlipoproteinämie die Aktivität des Lipoproteinlipase-Systems bei meist normaler postheparinlipolytischer Aktivität (9) (9). Die Chylomikronen aus dem Ductus thoracicus sind durch den lipoproteinlipaseabhängigen Katabolismus nicht beeinflußt.…”

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Xantinol-nicotinat bei primärer Typ-V-Hyperlipoproteinämie

Haacke¹,

Mr²,

Mäder³

1976

Dtsch med Wochenschr

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The effect of xantinol-nicotinate (50 mg/kg body-weight) on serum lipids and lipoproteins was tested in 16 out-patients with primary type V hyperlipoproteinaemia. The lipids and lipoproteins were measured before treatment, during a three-week period of drug administration and ten days after it had been stopped. There were no side effects such as flushing or gastritis, and no notable reduction of weight. Each serum-lipid fraction (triglycerides, nonesterified fatty acids, phospholipids, ester-cholesterol and free cholesterol) decreased significantly, regaining the initial values ten days after the drug had been stopped. While chylomicrons and very low-density lipoproteins (VLDL) decreased, there was a significant increase in low-density lipoproteins (LDL). High-density lipoproteins were not significantly changed. The decrease in chylomicrons and the significant decrease in VLDL with xantinol-nicotinate was opposite to that seen with dietary treatment. In none of the patients did LDL increase to abnormally high levels.

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“…Während für die klassische Form (Typ Bürger-Grütz) meist angenommen wird, daß eine Retentionshyperlipämie vorliegt, das heißt, daß die Entfernung normal resorbierter Fette aus dem Plasma gestört ist, wurde auch eine Fehleinstellung eines lipostatisdien Mechanismus erwogen. Bei einer Anzahl (bisher einigen zwanzig) von Familien konnte die Störung auf eine mangelnde Aktivität der Lipoproteidlipase zurückgeführt werden (11,14,17,18,19). Nach Heparingabe tritt in diesen Fällen keine Lipämieklärung ein.…”

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Untersuchungen über die Fettsäuren der Plasmalipide bei erbbedingter kohlenhydratsensitiver Hyperlipidämie^*¹

Fuhrmann¹

1964

Dtsch med Wochenschr

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Die erblichen Hyperlipidämien bieten besondere differentialdiagnostische Schwierigkeiten. Die Vermehrung einer Lipidfraktion des Plasmas ist stets von einem mehr oder weniger ausgesprochenen Anstieg der übrigen Plasmalipide begleitet. Ubereinstimmung herrscht heute über die Abgrenzung der idiopathischen familiären Hypertholesterinämie mit deutlicher Erhöhung des Gesamtcholesterins und der Phospholipide bei klarem Serum und etwa normaler Neutralfettkonzentration. Diagnostisch schwieriger zu beurteilen sind oft Fälle mit Hypercholesterinämie und sekundärer Neutralfettvermehrung. Die Abgrenzung kann hier mitunter nur unter Berück-sichtigung des gesamten klinischen Bildes und der Reaktion auf besondere Diätformen erfolgen. Einem Vorschlag Fredericksons entsprechend sollte man sich, wenn eine exaktere Einordnung nicht möglich ist, auf den übergeordneten Begriff Hyperlipidämie beschränken Professor Dr. A. Loesdike zum 60. Geburtstag.

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Lipolytic activity of post-heparin plasma in hyperglyceridemia

Cited by 328 publications

References 23 publications

Hypertriglyceridemic Pancreatitis Caused by the Oral Contraceptive Agent Estrostep

Hypertriglyceridemic Pancreatitis Caused by the Oral Contraceptive Agent Estrostep

Xantinol-nicotinat bei primärer Typ-V-Hyperlipoproteinämie

Untersuchungen über die Fettsäuren der Plasmalipide bei erbbedingter kohlenhydratsensitiver Hyperlipidämie^*¹

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Lipolytic activity of post-heparin plasma in hyperglyceridemia

Cited by 328 publications

References 23 publications

Hypertriglyceridemic Pancreatitis Caused by the Oral Contraceptive Agent Estrostep

Hypertriglyceridemic Pancreatitis Caused by the Oral Contraceptive Agent Estrostep

Xantinol-nicotinat bei primärer Typ-V-Hyperlipoproteinämie

Untersuchungen über die Fettsäuren der Plasmalipide bei erbbedingter kohlenhydratsensitiver Hyperlipidämie*1

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Untersuchungen über die Fettsäuren der Plasmalipide bei erbbedingter kohlenhydratsensitiver Hyperlipidämie^*¹