Any ideas please ??
I think I must be missing something....
I saw a new patient in clinic yesterday with a very odd series of lipid results
54 yr old Caucasian female( not from Luton, but Harpenden) non smoker, type 2 DM ( HbA1c never high according to GP), BMI 35, minimal alcohol consumption
No clinical stigmata of hyperlipidaemia
Drug History
Metformin
Amlodipine
Candesartan,
Venlafaxine
Femoston
Inhalers for asthma
No other real PMH
June 2011
Tg 45.0, Chol 8.4 mmol/L
Gp started her on Simvastatin 40mg !!
July 2011
Tg 5.2 , Chol 4.1 mmol/L
No bloods for 12 months
21/8/12
Tg 29.6, Chol 15.2 HBA1c 51mmol/mol
30/8/12
Tg 93.0, Chol 20.4mmol/L
All above samples assayed at another lab using Vitros and GP lab reports say samples were lipaemic
She was still on Simvastatin 40mg
Gp phoned me on 13th Sept and I told her to stop Statin and give her Ciprofibrate 100mg nocte,( so had been taking it for 1 week) and saw her yesterday
Her fasting lipids today on Beckman
Tg 4.4, Chol 4.0, HDL 1.84 mmol/L
FBC ( and MCV),LFT and U and E normal
Patient denies any excessive indulgence in fatty foods.
Any ideas why this patient had 3 out of 4 such deranged results...?
My colleague suggested we give her a “ Pizza and chips challenge”.....
Many thanks
Regards
Danielle
Dr Danielle B. Freedman MB BS, FRCPath,EurClinChem
Divisional Director
Diagnostics, Therapeutics and Outpatients
Luton and Dunstable University Hospital NHS FT
Luton, LU4 0DZ
+441582 497212
