15 April 2024
: Case report
Complicated Treatment Course of Severe Asymptomatic Hypertriglyceridemia: A Case Report and Literature Review
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Adverse events of drug therapy, Educational Purpose (only if useful for a systematic review or synthesis)
Ahmad Wasfi Haddad
DOI: 10.12659/AJCR.943858
Am J Case Rep 2024; 25:e943858
Table 2. Lipid panel, liver enzymes, and ongoing treatment.
Day | TG level normal range (0–150 mg/dl) | Cholesterol normal range (125–200 mg/dl) | LDL Normal range (0–100 mg/dl) | AST/ALT UL AST Normal range (10–36 U/L), ALT normal range (9–46 U/L) | Ongoing treatment |
---|---|---|---|---|---|
At the clinic, 4 weeks before admission | 11370 | 806 | 207 | 34/38 | Atorvastatin 40 mg, fenofibrate, and lifestyle modification |
Day 1 (day of admission) | 9050 | 594 | 202 | 951/1100 | Atorvastatin 40 mg, fenofibrate discontinued, started insulin drip 0.10 units/kg/h |
Day 3 | 6930 | 563 | 201 | 369/995 | Insulin rate increased to 0.14 units/kg/h |
Day 5 | 1532 | 543 | 203 | 277/806 | Insulin rate 0.14 units/kg/h |
Day 7 | 822 | 464 | 201 | 229/751 | Insulin rate decreased to 0.10 units/kg/h |
Day 9 | 729 | 423 | 199 | 84/527 | Insulin infusion was held. Started on subcutaneous insulin 0.5 units/kg/day |
Day 11 (day of discharge) | 600 | 411 | 204 | 49/215 | Subcutaneous insulin 0.5 units/kg/day. Fenofibrate 53 mg started |
After 2 weeks of discharge | 430 | 390 | 193 | 32/48 | Subcutaneous insulin stopped. Fenofibrate 53 mg started |
8 weeks after discharge | 290 | 371 | 191 | 28/41 | Fenofibrate was held. Lifestyle modifications, and atorvastatin 40 mg started |
12 weeks after discharge | 279 | 255 | 179 | 31/38 | Lifestyle modifications and atorvastatin 40 mg for primary and secondary prevention |