We thought we had a record at 237 mmol/L for serum tr
Colleagues,
We thought we had a record at 237 mmol/L for serum triglycerides (+/- ???) (details in Int Med Journal 2006;36:682-686 and poster (with colour pictures) at http://www.sydpath.stvincents.com.au/other/AACB2003.htm but a keen reader of the literature found "276.6" mmol/L in Eur J Chem Clin Biochem 1997;35:101-3.
This case was of interest to me for 2 reasons:
1. We could get pretty cealr serum with 3 hours in a microfuge (we no longer have an ultra centrifuge)
2. My assumption with this type of case is that the rate of removal of trigylcerides from chylomicrons and VLDL is very slow, so the next meal further exacerbates the problem. After admission and plaement nil by mouth the triglycerides very very rapidly, appearing to clear much more rapidly in absolute terms than "normal" (ie the patient reduced trigs by 120 mmol/L in 1 day where we recommend allowing 12 hours to clear chylomicrons after a normal meal). Alcohol was a key factor prior to admission and obviously was ceased on admission - could this be a key factor in the rate of lipid clearance in such cases?
Regards,
Graham
Graham Jones
Staff Specialist in Chemical Pathology
St Vincent's Hospital, Sydney
Ph: (02) 8382-9160
Fax: (02) 8382-2489
>>> Mohammad Al-Jubouri <[log in to unmask]> 14-May-07 7:26:07 pm >>>
31-year-old man, uncontrolled type 1 diabetes (HbA1c 16.4%) with microalbuminuria, attended diabetic OPD and had his lipids checked:
LIPID PROFILE
Cholest. H 34.50 mmol/L
Trigly. H 179 mmol/L
HDL-C H 2.40 mmol/L
LDL-C NA mmol/L
Looked at his sample out of the fridge this morning and it wasn't even full fat milk consistency, it was like a solid clotted cream with no discernible serum above or below the creamy clot.
Q1: is this a record triglcerides?
Q2: is it all due to uncontrolled type1 diabetes?
Q3: is it worth measuring LPL and apo CII ...etc?
Q4: would you admit for hospital care, what is his individual risk of developing acute pncreatitis?
Many thanks
Mohammad
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
---------------------------------
All New Yahoo! Mail * Tired of unwanted email come-ons? Let our SpamGuard protect you.
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
**********************************************************************
This email and any files transmitted with it are confidential and
intended solely for the use of the individual or entity to whom they
are addressed. If you have received this email in error please notify
the system manager.
This footnote also confirms that this email message has been virus
scanned and although no viruses were detected by the system, St Vincents &
Mater Health Sydney accepts no liability for any consequential damage
resulting from email containing any computer viruses.
**********************************************************************
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|