Treatment of Pegylated Asparaginase-Induced Hypertriglyceridemia with Continuous Intravenous Infusion of Insulin and Heparin: A Case Report.
Asparaginase
/ adverse effects
Cholesterol
/ blood
Diet, Fat-Restricted
Heparin
/ therapeutic use
Humans
Hypertriglyceridemia
/ drug therapy
Infusions, Intravenous
Insulin
/ therapeutic use
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
/ drug therapy
Male
Middle Aged
Pancreatitis
/ etiology
Polyethylene Glycols
/ adverse effects
Triglycerides
/ blood
Acute lymphoblastic leukemia
Heparin
Hypertriglyceridemia
Insulin
Pegylated asparaginase
Journal
Chemotherapy
ISSN: 1421-9794
Titre abrégé: Chemotherapy
Pays: Switzerland
ID NLM: 0144731
Informations de publication
Date de publication:
2019
2019
Historique:
received:
24
10
2019
accepted:
06
01
2020
pubmed:
12
2
2020
medline:
21
3
2020
entrez:
12
2
2020
Statut:
ppublish
Résumé
Pegylated asparaginase may induce prolonged hypertriglyceridemia. To date, there is no standard management of this complication. Here, we present a case report of pegylated asparaginase-induced hypertriglyceridemia and hepatotoxicity successfully treated with continuous intravenous infusion of insulin and heparin. A 51-year-old male patient with lymphoid blast crisis of chronic myelogenous leukemia was treated with pegylated asparaginase. The patient developed severe hypertriglyceridemia. Supportive therapy with low-fat diet, fibric acids, and omega-3 fatty acids was not successful, and later, the patient developed high-grade hepatotoxicity. Like hypertriglyceridemia-induced pancreatitis, continuous intravenous infusion of insulin and heparin was initiated. The level of triglyceride and cholesterol decreased rapidly within 4 days. In case of severe pegylated asparaginase-induced hypertriglyceridemia, continuous intravenous infusion of insulin and heparin can reduce rapidly and safely the triglyceride level. Controlled trials are needed to address this important issue.
Sections du résumé
BACKGROUND
BACKGROUND
Pegylated asparaginase may induce prolonged hypertriglyceridemia. To date, there is no standard management of this complication. Here, we present a case report of pegylated asparaginase-induced hypertriglyceridemia and hepatotoxicity successfully treated with continuous intravenous infusion of insulin and heparin.
CASE PRESENTATION
METHODS
A 51-year-old male patient with lymphoid blast crisis of chronic myelogenous leukemia was treated with pegylated asparaginase. The patient developed severe hypertriglyceridemia. Supportive therapy with low-fat diet, fibric acids, and omega-3 fatty acids was not successful, and later, the patient developed high-grade hepatotoxicity. Like hypertriglyceridemia-induced pancreatitis, continuous intravenous infusion of insulin and heparin was initiated. The level of triglyceride and cholesterol decreased rapidly within 4 days.
CONCLUSION
CONCLUSIONS
In case of severe pegylated asparaginase-induced hypertriglyceridemia, continuous intravenous infusion of insulin and heparin can reduce rapidly and safely the triglyceride level. Controlled trials are needed to address this important issue.
Identifiants
pubmed: 32045924
pii: 000505773
doi: 10.1159/000505773
doi:
Substances chimiques
Insulin
0
Triglycerides
0
Polyethylene Glycols
3WJQ0SDW1A
pegaspargase
7D96IR0PPM
Heparin
9005-49-6
Cholesterol
97C5T2UQ7J
Asparaginase
EC 3.5.1.1
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
210-214Informations de copyright
© 2020 S. Karger AG, Basel.