Presentation
To describe an extreme presentation of the chylomicronemia syndrome resulting in multiorgan system dysfunction. [ncbi.nlm.nih.gov]
Presently, the company is conducting an international multi-centre, randomised, double-blind, placebo-controlled Phase three study in patients with Familial Chylomicronemia Syndrome. i) Familial Chylomicronemia Syndrome with either Lipoprotein Lipase [medical-dictionary.thefreedictionary.com]
Entire Body System
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Hypoxemia
Pulmonary function tests, red cell 2,3-diphosphoglycerate, and hemoglobin oxygen affinity were normal; the mild hypoxemia observed is believed to be an artifact. [ncbi.nlm.nih.gov]
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Medication Noncompliance
His hypertriglyceridemia had been poorly controlled, because of medication noncompliance. He did not use any medication for his severe hypertriglyceridemia since one year. The patient did not smoke or consume alcohol. [omicsonline.org]
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Noncompliance
His hypertriglyceridemia had been poorly controlled, because of medication noncompliance. He did not use any medication for his severe hypertriglyceridemia since one year. The patient did not smoke or consume alcohol. [omicsonline.org]
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Hunting
"Going to a restaurant is difficult, and the grocery store becomes like a hunt — I have to read labels closely," he said. He can eat lots of greens, steamed vegetables, turkey, chicken, lean pork and fish. [pamplinmedia.com]
Immune System
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Splenomegaly
Although the patient had a positive history for recurrent episodes of pancreatitis the characteristic lesions of the hyperchylomicronemia syndrome, such as eruptive xanthomas and lipemia retinalis, were not present and splenomegaly could not be documented [ncbi.nlm.nih.gov]
Eye fundus examination found lipemia retinalis, and abdominal palpation revealed hepatomegaly with no splenomegaly. [elsevier.es]
Hepatomegaly is common, and, if the plasma TG levels are very high, splenomegaly may also be seen. Organomegaly occurs as a result of TG uptake by macrophages, which become foam cells and may rapidly regress with a decrease in dietary fat intake. [clinicaladvisor.com]
Disease, diseased - see also Syndrome Bürger-Grütz E78.3 (essential familial hyperlipemia) chylomicron retention E78.3 Frederickson's hyperlipoproteinemia, type I and V E78.3 Hepatosplenomegaly R16.2 ICD-10-CM Diagnosis Code R16.2 Hepatomegaly with splenomegaly [icd10data.com]
Respiratoric
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Dyspnea
The chylomicronemia syndrome is associated with marked hypertriglyceridemia (plasma triglyceride level above 2000 mg per dl), abdominal pain or pancreatitis, eruptive xanthomata, lipemia retinalis, dyspnea, mental aberrations, and other minor findings [ncbi.nlm.nih.gov]
However, people with this syndrome, at the onset of symptoms usually have triglyceride elevations greater than 2000 mg/dL, or 22.6 mmol/L and provide a history of recurrent episodes of: abdominal pain, sometimes with nausea vomiting, or dyspnea shortness [reducetriglycerides.com]
Other presenting symptoms may include diarrhea, internal bleeding and dyspnea. LPL deficiency is unlikely to be associated with atherosclerosis but recurrent pancreatitis may be life-threatening. [clinicaladvisor.com]
Recurrent episodes of ill-defined abdominal pain that may be accompanied by nausea and vomiting are the most common presenting symptom, but chest pain and dyspnea may sometimes occur. [emedicine.medscape.com]
Gastrointestinal
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Abdominal Pain
pain and pancreatitis can be recurrent. 2 In one study, 59% of patients with FCS had a history of recurrent abdominal pain without hospitalization and 50% had a history of recurrent pancreatitis (ranging from 2-96 episodes). 30 FCS can be diagnosed when [fcs.raredr.com]
The chylomicronemia syndrome is associated with marked hypertriglyceridemia (plasma triglyceride level above 2000 mg per dl), abdominal pain or pancreatitis, eruptive xanthomata, lipemia retinalis, dyspnea, mental aberrations, and other minor findings [ncbi.nlm.nih.gov]
Symptoms While severe abdominal pain is the most common symptom of FCS, the symptoms of FCS can be clinical, emotional and cognitive and may include (Brahm and Hegele, 2015; Davidson et al. 2017): abdominal pain (daily low-level to debilitating) nausea [pancreasfoundation.org]
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Chronic Abdominal Pain
Chronic abdominal pain, mental confusion, and memory loss improved with lipid-lowering therapy and clearing the plasma of chylomicrons. [ncbi.nlm.nih.gov]
For most patients, the most common symptoms are chronic abdominal pain and acute pancreatitis. Pancreatitis can be a life threatening condition and can lead to problems such as diabetes and pancreatic insufficiency. [patientworthy.com]
The clinical burden of FCS includes chronic abdominal pain and pancreatitis. Acute pancreatitis causes debilitating pain, anxiety, loss of employment, and hospitalizations. [pancreasfoundation.org]
Liver, Gall & Pancreas
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Hepatosplenomegaly
Chylomicronemia syndrome (CMS) is a rare disorder characterized by the presence of chylomicrons in the fasting state causing a milky appearance of plasma, eruptive xanthomas, and hepatosplenomegaly; an acute and potentially life threatening complication [ncbi.nlm.nih.gov]
[…] acute recurrent inflammation of the pancreas, which causes debilitating pain and can be fatal. 6-8 Others develop eruptive xanthomas (fatty deposits on the skin) lipemia retinalis (milky appearance of retinal veins and arteries), abdominal pain, and hepatosplenomegaly [fcs.raredr.com]
The impact of FCS includes acute physical manifestations (eruptive xanthoma, lipemia retinalis, hepatosplenomegaly) and potentially life-threatening recurrent acute pancreatitis, which frequently leads to chronic pancreatitis,” Brown and colleagues wrote [healio.com]
[…] fatigue impaired memory difficulty concentrating and problem solving “brain fog” anxiety/fear/worry about health eruptive xanthomas (pink bumps that appear on your body, arms and legs) lipaemia retinalis (milky appearance of blood vessels in the eye) hepatosplenomegaly [pancreasfoundation.org]
R16.2 ICD-10-CM Diagnosis Code R16.2 Hepatomegaly with splenomegaly, not elsewhere classified 2016 2017 2018 2019 Billable/Specific Code Applicable To Hepatosplenomegaly NOS hyperlipemic E78.3 (Bürger-Grütz type) Hyperchylomicronemia (familial) (primary [icd10data.com]
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Hepatomegaly
An abdominal ultrasound examination confirmed hepatomegaly. [elsevier.es]
Hepatomegaly is enlargement of the liver beyond its normal size. [mountsinai.org]
An enlarged liver (hepatomegaly) is also common. Hepatomegaly is caused by the accumulation of fat in the liver (fatty liver or steatosis). [rarediseases.org]
Hepatomegaly is common, and, if the plasma TG levels are very high, splenomegaly may also be seen. Organomegaly occurs as a result of TG uptake by macrophages, which become foam cells and may rapidly regress with a decrease in dietary fat intake. [clinicaladvisor.com]
Cardiomegaly Debranching enzyme deficiency Cori disease clinical manifestations Hypotonia, hepatomegaly Shows limit dextrins accumulation Myophosphorilase deficiency Mcardle diseases manifestations - High glycogen in muscle - Muscle cramps - Myoglobinuria [quizlet.com]
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Biliary Colic
It should be noted that the presentation of hyperchylomicronemia may be confused with conditions such as: acute myocardial syndromes and biliary colic - a condition characterized by severe cramping pain in the right upper abdomen due to gallstones in [reducetriglycerides.com]
Skin
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Xanthoma
The xanthomas are the aggregates of chylomicrons that have become large enough to see on the exterior of the skin. [chylomicronemiasyndrome.wordpress.com]
Chylomicronemia, when accompanied by eruptive xanthoma, lipemia retinalis, or abdominal symptoms, is referred to as the "chylomicronemia syndrome" and can cause acute pancreatitis. [ncbi.nlm.nih.gov]
Abstract A 25-year-old man who presented with eruptive xanthomas, hyperglycemia and hyperlipidemia was admitted to our hospital. [jstage.jst.go.jp]
Eyes
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Lipemia Retinalis
The chylomicronemia syndrome is associated with marked hypertriglyceridemia (plasma triglyceride level above 2000 mg per dl), abdominal pain or pancreatitis, eruptive xanthomata, lipemia retinalis, dyspnea, mental aberrations, and other minor findings [ncbi.nlm.nih.gov]
Ophthalmological examination revealed lipemia retinalis. [omicsonline.org]
Neurologic
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Difficulty Concentrating
People with FCS report fatigue, weakness, fear, worry, cognitive impairment such as impaired memory and difficulty concentrating. [pancreasfoundation.org]
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Peripheral Neuropathy
neuropathy - Dermatitis - Anemia - Carboxylation enzymes ex. [quizlet.com]
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Unable to Walk
I had experienced abdominal pain before, but this was different; the pain was so excruciating I was unable to walk. [globalgenes.org]
Workup
A thorough history, physical examination, and laboratory workup failed to identify a clear etiology of the extremely abnormal blood lipid level, prompting genetic investigation to identify the genetic cause of the milky serum. [lipidworld.biomedcentral.com]
See Workup for more detail. [emedicine.medscape.com]
Serum
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Hypertriglyceridemia
The marked hypertriglyceridemia is usually due to the interaction of a common familial form of hypertriglyceridemia and a common acquired form of hypertriglyceridemia secondary to another disease, drug, or alcohol. [ncbi.nlm.nih.gov]
His hypertriglyceridemia had been poorly controlled, because of medication noncompliance. He did not use any medication for his severe hypertriglyceridemia since one year. The patient did not smoke or consume alcohol. [omicsonline.org]
Treatment
The clinical manifestations--lipid and other biochemical abnormalities--as well as treatment options for chylomicronemic patients are discussed. [ncbi.nlm.nih.gov]
The product is intended for the treatment of patients with Familial Chylomicronemia Syndrome. [medical-dictionary.thefreedictionary.com]
Prognosis
Therefore, the prognosis of individuals with chylomicronemia syndrome is not so bleak after all. They can lead a relatively normal life, and to be honest, with a healthier diet than many people without the disease. [chylomicronemiasyndrome.wordpress.com]
Outlook (Prognosis) A fat-free diet can reduce symptoms dramatically. Possible Complications When untreated, the excess chylomicrons may lead to bouts of pancreatitis. This condition can be very painful and even life threatening. [ufhealth.org]
Affected individuals should talk to their physician and medical team about their specific case, associated symptoms, and overall prognosis. [rarediseases.org]
Etiology
Abstract Hypertriglyderidemia is responsible for up to 10% of cases of pancreatitis, appearing as the third most common etiology. [galiciaclinica.info]
Hegele Hypertriglyceridemia: its etiology, effects and treatment [4] N. Chokshi, S.D. Blumenschein, Z. Ahmad, A. Garg Genotype–phenotype relationships in patients with type I hyperlipoproteinemia [5] T. Gotoda, K. Shirai, T. Ohta, J. Kobayashi, S. [elsevier.es]
Other etiologic factors were excluded, including mutations in the PRSS1, SPINK1, and CFTR gene. Although both brothers had recurrent acute pancreatitis and the same LPL genotype, CP became evident in only one patient. [journals.lww.com]
In our cases, genetic investigation could help to identify the etiology of infants with milky serum for the heterogeneity of FCS in the young group. [lipidworld.biomedcentral.com]
[…] of Hypertriglyceridemia Hypertriglyceridemia has been classified as primary when the cause is genetic, and as secondary when the etiology relates to other diseases that affect triglyceride metabolism, medications, or dietary factors. [cmecorner.com]
Epidemiology
[…] treated with it commercially. [7] A total of 31 patients were treated with Glybera, most for free in clinical trials before the drug was taken off the market. [8] Incidence [ edit ] The disorder affects about 1 out of 1,000,000 people; [9] however, epidemiological [en.wikipedia.org]
: Lipoprotein (a): molecular and epidemiologic basis about its role in cardiovascular diseases. Revista Latinoamericana de Hipertensión. 2008; 3 (4): 113–122. Reference Source 46. [f1000research.com]
[…] patients with type 2 diabetes found no effect of combination therapy with fenofibrate and a statin on the primary endpoint of fatal cardiovascular events, nonfatal MI or nonfatal stroke (HR 0.92; 95% CI 0.79-1.08; p 0.32). 40 After reviewing evidence from epidemiological [cmecorner.com]
In epidemiologic and interventional studies, hypertriglyceridemia is a risk factor for coronary artery disease (CAD). [emedicine.medscape.com]
JPN guidelines for the management of acute pancreatitis: Epidemiology, etiology, natural history, and outcome predictors in acute pancreatitis. J Hepatobiliary Pancreat Surg 2006;13(1):10-24. Kumar J, Wierzbicki AS. Images in clinical medicine. [nanbyou.or.jp]
Pathophysiology
This review discusses the chylomicronemia syndrome presenting the pathophysiologic characteristics of triglyceride and chylomicrons metabolism, diagnosis, prevalence and treatment. [ncbi.nlm.nih.gov]
Purpose/Learning Objectives: Upon successful completion of this educational activity, participants should be better able to: Assess the burden of FCS, its pathophysiology, and the importance of early diagnosis and treatment. [healio.com]
[…] hypercholesterolemia genetic mutations familial hypercholesterolaemia gene mutations familial cancer gene mutations familial frontotemporal dementia mutations familial gastric cancer mutations Lesson on Familial Hypercholesterolemia: Genetic Basis, Pathophysiology [web.shadidphotography.com]
Given the importance of apoC-III in lipid metabolism and its pathophysiological role in CVD and other metabolic disorders, it was an obvious target for therapeutic intervention. [dicardiology.com]
Pathophysiology of hypertriglyceridemia. Biochim Biophys Acta. 2012 May. 1821(5):826-32. [Medline]. [emedicine.medscape.com]
Prevention
Therapy that successfully lowers plasma triglyceride levels is associated with clearing of the symptoms and signs of the chylomicronemia syndrome and prevention of its recurrence. [ncbi.nlm.nih.gov]
Presented at: American Society for Preventive Cardiology Congress on Atherosclerotic Cardiovascular Disease Prevention; Sept. 16-18, 2016; Boca Raton, Fla. [healio.com]
Prevention There is no way to prevent someone from inheriting this syndrome. Images References Genest J, Libby P. Lipoprotein disorders and cardiovascular disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, Braunwald E, eds. [ufhealth.org]