Marked Hyperlipidemia and Pancreatitis Associated with Oral Contraceptive Therapy

Marked hyperlipidemia, recurrent episodes of abdominal pain and ultimately pancreatitis developed in two women receiving oral contraceptive agents. Chylomicrons were absent from initial and subsequent samples drawn during admission with acute pancreatitis. Since contraceptive therapy was stopped, they have remained symptom free, although mild elevations of endogenous triglycerides persist when they are on ad lib diets. In four other cases reported in the literature massive hyperlipidemia developed during oral contraceptive therapy. Two of these patients also had pancreatitis; laparotomies were performed on three of the total of four patients with pancreatitis for presumptive gallbladder disease. These experiences suggest caution in the use of oral contraceptives in patients with Type 4 hyperlipidemia, and should alert physicians to the possibility of pancreatitis secondary to hyperlipidemia in patients receiving these agents. (N Engl J Med 289:552–555, 1973)