Key result
A 45-year-old woman developed severe acquired hypertriglyceridemia (44.0 mmol/L) due to transient lipoprotein lipase inhibition following COVID-19, which resolved to 1.4 mmol/L with fibrate therapy and a very-low-fat diet.
Why the study?
Severe hypertriglyceridemia is occasionally caused by plasma components inhibiting lipoprotein lipase activity, typically in autoimmune diseases, but post-COVID-19 occurrence required characterization.
Case Report (n=1)
Absolute Event Rate: 1.4% vs 44%
COVID-19 may cause transient severe hypertriglyceridemia due to reduced lipoprotein lipase activity, which can be managed with fibrates and diet.
Post-COVID transient LPL inhibition may cause severe hypertriglyceridemia; leaves open its role in pancreatitis risk beyond this case.
Severe hypertriglyceridemia is a major risk factor for acute pancreatitis. In exceptional cases, it is caused by plasma components inhibiting lipoprotein lipase activity. This phenomenon is predominantly associated with autoimmune diseases. Here, we report a case of severe hypertriglyceridemia due to a transient reduction in lipoprotein lipase activity following an episode of COVID-19 in an otherwise healthy 45-year-old woman. The lipoprotein lipase activity of the patient was markedly reduced compared with a healthy control and did recover to 20% of the healthy control's lipoprotein lipase activity 5 months after the COVID-19 episode. Mixing tests substantiated reduced lipolytic capacity in the presence of the patient's plasma at presentation compared with a homozygous lipoprotein lipase-deficient control, which was no longer present at follow-up. Western blotting confirmed that the quantity of lipoprotein lipase was not aberrant. Fibrate treatment and a strict hypolipidemic diet improved the patient's symptoms and triglyceride levels.
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Fijen et al. (2021) conducted a case report in Severe acquired hypertriglyceridemia (n=1). Fibrate and very-low-fat diet was evaluated on Triglyceride levels. A 45-year-old woman developed severe acquired hypertriglyceridemia (44.0 mmol/L) due to transient lipoprotein lipase inhibition following COVID-19, which resolved to 1.4 mmol/L with fibrate therapy and a very-low-fat diet.
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