Subcutaneous NPH Insulin for Severe Hypertriglyceridemia in a Pregnant Patient with Type V Hyperlipoproteinemia: a Case Report

摘要

An increase in triglyceride levels in familial hyperlipidemia during pregnancy has been reported. Severe hypertriglyceridemia can lead to complications such as acute pancreatitis, preeclampsia, maternal and fetal complications. Because of the teratogenic effects associated with fibrate therapy in pregnancy, alternative treatment strategies such as insulin as a rapid and potent activator of lipoprotein lipase are required during pregnancy. We report a case of hypertriglyceridemia in a 33-year-old pregnant woman in whom treatment with merely single one time administration of Neutral Protamine Hagedorn insulin was accompanied by a reduction in the serum triglyceride level; to the best of our knowledge, this has never been reported in the literature. Her triglyceride level was 3616 mg/dL before insulin treatment and 1246 mg/dL after insulin treatment. Although this regimen was used safely and effectively in our patient, comprehensive studies are required to evaluate the effectiveness and safety of subcutaneously intermediate-acting Neutral Protamine Hagedorn insulin for the treatment of severe hypertriglyceridemia in non-diabetic pregnant women. Turkish Ba?l?k: Tip V Hiperlipoproteinemili Gebe Bir Hastada ?iddetli Hipertrigliseridemi ??in Verilen Subkutan NPH Insulin Tedavisi: Vaka Sunumu Anahtar Kelimeler: Hamilelik, hipertrigliseridemi, insülin Gebelerde ve familyal hiperlipidemilerde gebelik s?ras?nda trigliserit düzeylerinde art?? olmaktad?r. ?iddetli hipertrigliseridemi akut pankreatit, preeklampsi, anne ve bebekte komplikasyonlara yol a?abilir. Gebelik d?neminde fibrat tedavisinin teratojenik etkilerinden dolay?, lipoprotein lipaz?n h?zl? ve gü?lü bir aktivat?rü olan insulin gibi alternatif tedavi y?ntemleri gerekebilir. Biz, serum trigliserid düzeylerini azaltmak amac? ile sadece tek doz N?tral Protamin Hadegorn insulin ile tedavi etti?imiz, literatürde daha ?nceden rapor edilmemi? 33 ya??nda hipertrigliseridemisi olan gebe bir hastay? bildirdik. Hastan?n insulin tedavi ?ncesi trigliserid düzeyi 3616 mg/dl iken tedavi sonras? 1246 mg/dl oldu. Bu tedavi rejimi hastam?zda etkili ve güvenli olmas?na kar??n, diyabetik olmayan ?iddetli hipertrigliseridemik gebelerde subkutan yolla verilen orta etkili N?tral Protamin Hadegorn insülinin etkinli?ini ve güvenilirli?ini de?erlendirecek kapsaml? ?al??malara gerek vard?r.