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Hypertriglyceridaemia in pregnancy: an unexpected diagnosis and its management
  1. Kathryn Barclay1,
  2. Kanyada Koysombat1,
  3. Radhika Padmagirison2 and
  4. Felicity Kaplan1
  1. 1Department of Endocrinology and Diabetes Mellitus, Lister Hospital, Stevenage, UK
  2. 2Department of Obstetrics and Gynaecology, Lister Hospital, Stevenage, UK
  1. Correspondence to Dr Kathryn Barclay; kathryn.barclay{at}


A woman in her 30s with gestational diabetes presented at 36 weeks’ gestation with reduced fetal movements and diminishing insulin requirements. In view of her gestation, she was induced and incidentally found to have profound hyponatraemia. Further biochemical investigations confirmed severe hypertriglyceridaemia and hypercholesterolaemia. This raises the possibility of secondary causes such as familial dysbetalipoproteinemia and polygenetic hypertriglyceridaemia. She was successfully managed by aggressive dietary modification. This involved a supervised fast followed by a fat-free diet. A fenofibrate was proposed but declined due to our patient’s wish to breastfeed. Management required considerable input from the multidisciplinary team. Treatment options to consider are aggressive dietary restriction of fat or the addition of a cholesterol-lowering medication, such as a fibrate. In refractory cases, a supervised fast may be required or, in cases where complications have arisen, apheresis. The patient and her baby made a good recovery with no long-lasting health implications.

  • Lipid disorders
  • Metabolic disorders
  • Diabetes
  • Pregnancy
  • Nutrition and metabolism

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  • Contributors KB and KK prepared the manuscript and performed literature review. RP and FK provided guidance and edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.