Abstract
A twenty-eight year old woman suffering from chylomicronemia with acute pancreatitis during pregnancy was presented, she had had diabetes mellitus 4 years ago. She was admitted complaining of fever, and severe epigastralgia. The fetus died on the sixth day after admission. The serum triglyceride was 7592mg/dl, total cholesterol 1706mg/ml, FFA 5.58mEq/l, and amylase was within normal limits in the serum and in the urine. The serum was grossly creamy, and lipemia retinalis was discovered. A high concentration of prebeta lipoprotein was also present. The patterns thus closely resembled those of genetically determined type V hyper-lipemia as described by Fredrickson et al. This patient had no family history of similar illnesses. Chylomicronemia had already appeared before the episode of acute pancreatitis. These findings indicated that the hyperlipemia might have been a cause of the pancreatitis. Probe laparotomy revealed the number of granuloma pseudoxanthomatodes around the pancreas which showed the healed pancreatitis. It should be noted that the lipids of the fetus were within normal limit.
The primary cause of this chylomicronemia was considered to be insulin deficiency in the diabetic state and pregnancy, chiefly being due to the reduction of lipoprotein lipase activity.
