Key result
Continuous insulin infusion decreased triglycerides from 4640 mg/dL to 522 mg/dL over 9 days in a pediatric patient with pegaspargase-induced severe hypertriglyceridemia.
Why the study?
Does continuous insulin infusion reduce triglyceride levels in a pediatric patient with pegaspargase-induced severe hypertriglyceridemia?
Case Report (n=1)
Does continuous insulin infusion reduce triglyceride levels in a pediatric patient with pegaspargase-induced severe hypertriglyceridemia?
Continuous insulin infusion successfully reduced severe pegaspargase-induced hypertriglyceridemia in a pediatric leukemia patient.
May support insulin infusion in refractory cases; hypothesis-generating and requires prospective trials before practice change.
We describe a pediatric patient with acute leukemia who developed an uncommon but significant metabolic consequence of pegaspargase therapy-severe hypertriglyceridemia (hyperTG). We also relate our experience with continuous insulin infusion treatment for pegaspargase-induced hyperTG. This treatment approach led to a decrease in triglycerides from 4640 mg/dL on admission to 522 mg/dL at discharge 9 days later. Genetic testing revealed that our patient was an apolipoprotein E 3/4 heterozygote. Our review of the literature suggests that apolipoprotein E polymorphism may influence the development of hyperlipidemia in acute lymphoblastic leukemia patients receiving asparaginase therapy and may identify patients at high risk for developing asparaginase-induced hyperTG.
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Lawson et al. (2011) conducted a case report in Severe hypertriglyceridemia associated with pegaspargase therapy (n=1). Continuous insulin infusion was evaluated on Triglyceride levels. Continuous insulin infusion decreased triglycerides from 4640 mg/dL to 522 mg/dL over 9 days in a pediatric patient with pegaspargase-induced severe hypertriglyceridemia.
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