Severe hypertriglyceridemia during pregnancy in a hypothyroid patient: A case report and literature review

Normal pregnancy causes marked increases in lipids, but in women with underlying dyslipidaemia, this can lead to severe hypertriglyceridemia (triglyceride >1000 mg/dL) and acute pancreatitis. Coexisting conditions like diabetes and hypothyroidism further exacerbate this risk. We report a 34-year-old G2P1 woman at 32 weeks of gestation with type 2 diabetes and treated hypothyroidism who presented with acute pancreatitis and a serum triglyceride level of 33.8 mmol/L. Her management included therapeutic plasmapheresis, insulin infusion, and fenofibrate, followed by a planned elective caesarean section at 35 weeks, which resulted in the delivery of a healthy infant. This case highlights the critical need for vigilant lipid monitoring and a coordinated, multidisciplinary approach in high-risk pregnancies to prevent life-threatening complications and improve maternal and fetal outcomes.