The effect of pregnancy and two different contraceptive pills on serum lipids and lipoproteins in a woman with a type III hyperlipoproteinaemia pattern
| Autor: | C. Pavlou, D. P. R. Muller, D. McLintock, A. G. L. Whitelaw |
|---|---|
| Rok vydání: | 1978 |
| Předmět: |
Adult
medicine.medical_specialty Normal diet medicine.medical_treatment Population Blood lipids Hyperlipidemias Pregnancy Internal medicine Chylomicrons medicine Xanthomatosis Humans Clofibrate education Triglycerides education.field_of_study business.industry Obstetrics and Gynecology Estrogens medicine.disease Mestranol Lipids Pregnancy Complications Contraceptives Oral Combined Endocrinology Cholesterol Pill Female Combined oral contraceptive pill business medicine.drug Contraceptives Oral |
| Zdroj: | British journal of obstetrics and gynaecology. 85(2) |
| ISSN: | 0306-5456 |
| Popis: | We report a woman who had a moderate elevation of serum triglycerides with a type III pattern of hyperlipoproteinaemia when taking a normal diet. She developed eruptive xanthomata with a grossly raised serum triglyceride concentration and chylomicronaemia when pregnant and also when taking a combined oral contraceptive pill containing 50 microgram of oestrogen. The xanthomata cleared and the triglyceride level fell when the combined oral contraceptive pill was changed to one with a lower oestrogen content, clofibrate was prescribed and the diet was restricted in carbohydrate and fat. Persistent chylomicronaemia is a serious complication of pregnancy because of the risk of pancreatitis and the potential risk of fetal malnutrition. Treatment with diet and clofibrate is indicated. High oestrogen-containing contraceptive pills appear to be contraindicated in patients with type III or other hypertriglyceridaemic states.This case study reports moderate elevation of serum triglycerides in a woman with a Type III pattern of hyperlipoproteinemia, when taking a normal diet but drinking alcohol heavily, who developed eruptive xanthomata with a grossly raised triglyceride concentration and chylomicronemia when pregnant and also when taking a combined oral contraceptive pill (OC) containing 50 mcg of estrogen. In December 1973 the patient, then taking Norinyl 1, was switched to Eugynon 30 (30 mcg of ethinyl estradiol and .25 mg of levonorgestrel), and clofibrate (2 gm/day) was prescribed along with a low carbohydrate and fat content diet. By February 1974 the patient had lost weight, the skin lesions had cleared, serum lipid concentrations had fallen, and the electrophoretic beta-band pattern was normal. The patient became pregnant in October 1974, and by the second trimester of pregnancy xanthomata had recurred, but erratic treatment with clofibrate and diet regulation eventually lowered triglyceride levels and she delivered a 2.61-kg baby at 39 weeks. Persistent chylomicronemia is a serious complication of pregnancy because of the risk of pancreatitis and the potential risk of fetal malnutrition. Similarly, high estrogen-containing OCs are contraindicated in patients with Type III or other hypertriglycidemic states. |
| Databáze: | OpenAIRE |
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