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Case Reports
. 2021 Nov 11;14(11):e246698.
doi: 10.1136/bcr-2021-246698.

Severe acquired hypertriglyceridemia following COVID-19

Lauré M Fijen  1 , Aldo Grefhorst  2 , Johannes H M Levels  2 , Danny M Cohn  3
Affiliations
Case Reports

Severe acquired hypertriglyceridemia following COVID-19

Lauré M Fijen et al. BMJ Case Rep. .

Abstract

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.

Keywords: COVID-19; lipid disorders; pancreatitis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
LPL activity of the patient at presentation (first) and 2-month follow-up (second) relative to a healthy volunteer (control). LPL, lipoprotein lipase.
Figure 2
Figure 2
Free glycerol-corrected triglycerides during in vitro plasma mix incubation of plasma from a healthy control and 0% and 50% plasma from our case (A) at presentation and (B) at 2-month follow-up compared with (C) plasma from a healthy control mixed with 0% and 50% plasma from a patient with congenital homozygous LPL deficiency. LPL, lipoprotein lipase.
Figure 3
Figure 3
Western blot of lipoprotein lipase quantity of the patient at presentation (first) and 2-month follow-up (second), compared with a healthy volunteer. FL, full-length; N-ter, N-terminal.
See this image and copyright information in PMC

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