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Severe acquired hypertriglyceridemia following COVID-19
Lauré M Fijen1, Aldo Grefhorst2, Johannes H M Levels2
1Vascular Medicine, Cardiovascular Sciences, University of Amsterdam, Amsterdam UMC Location AMC, Amsterdam, The Netherlands l.m.fijen@amsterdamumc.nl.
BMJ Case Reports
|November 12, 2021
Summary
A COVID-19 infection temporarily reduced lipoprotein lipase activity, causing severe hypertriglyceridemia in a healthy woman. This condition resolved over time, highlighting a novel post-viral complication.
Area of Science:
- Biochemistry
- Immunology
- Endocrinology
Background:
- Severe hypertriglyceridemia is a significant risk factor for acute pancreatitis.
- In rare instances, it stems from plasma factors inhibiting lipoprotein lipase (LPL) activity, often linked to autoimmune conditions.
Observation:
- A 45-year-old woman developed severe hypertriglyceridemia following a COVID-19 episode.
- Her lipoprotein lipase activity was markedly reduced, with mixing tests indicating reduced lipolytic capacity in her plasma.
Findings:
- Lipoprotein lipase activity recovered to 20% of normal within 5 months post-COVID-19.
- Western blotting confirmed normal lipoprotein lipase quantity, suggesting a functional inhibition rather than deficiency.
- Fibrate therapy and a hypolipidemic diet effectively managed triglyceride levels and symptoms.
Implications:
- COVID-19 can transiently impair lipoprotein lipase activity, leading to severe hypertriglyceridemia.
- This case expands the known causes of acquired LPL dysfunction beyond autoimmune diseases.
- Highlights the importance of monitoring lipid profiles in patients with post-viral complications.
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