Endocrine Abstracts

Background: Eruptive xanthomas, benign skin lesions, are rare and can be a sign of lipid metabolism abnormalities. This is an early indicator of the potential risks of pancreatitis and cardiovascular disease.

Case Presentation: A 57-year man admitted to the hospital due to elevated triglyceride level and poorly compensated type 2 diabetes. Main complaints were dry mouth and nocturia. No complaints of nausea, vomiting, stool changes or pain. There was data of previous episodes of acute pancreatitis and plasmapheresis due to dyslipidemia, as well as positive family history of sudden cardiac death. Upon examination the patient was overweight, with slightly elevated AP and no signs of abdominal tension. Small, raised, firm and painless yellow-red nodules throughout the body were discovered. In laboratory findings the lipid profile revealed a total cholesterol of 15,6 mmol/l, high-density lipoprotein of 0,39 mmol/l, low-density lipoprotein of 0,14 mmol/l and triglycerides of 58,0 mmol/l. The rest of plasmapheresis due to elevated lipids. The biochemical investigation was normal. In the imaging studies there were no signs of pancreatitis. Due to extremely high triglycerides patient received 4 plasmapheresis procedures, after which triglyceride level decreased to 5 mmol/l. Patient was treated with dapagliflozin, metformin, gliclazide, rosuvastatin/ezetimibe, omega fatty-acid, AKEi, CCB and indapamide. The patient was discharged with recommendation to make genetic screening for family hypertriglyceridemia.

Conclusions: Based on the medical history, family history, clinical investigation, the patient should be considered to have congenital familial hypertriglyceridemia, the treatment of which requires strong adherence to avoid secondary complications.