Very severe hypertriglyceridemia complicating pediatric acute lymphoblastic leukemia treatment: a call for management guidelines
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Carly L. Baxter
,
Elise G. Martin
Abstract
Objectives
Severe and very severe hypertriglyceridemia although rare within the pediatric population occur more often among oncology patients, secondary to chemotherapeutic agents. Currently there exists minimal literature to guide management of severe hypertriglyceridemia among pediatric patients. Very-low-fat dietary restriction should be considered over nil per os (NPO) for initial management of severe hypertriglyceridemia in stable pediatric patients. Pediatricians caring for oncology patients must consider chylomicronemia as a potential etiology for presenting symptoms. Pediatric severe hypertriglyceridemia management guidelines are needed as pediatricians must currently rely on anecdotal experiences for management decisions.
Case presentation
Three children receiving treatment for acute lymphoblastic leukemia required hospitalization for very severe hypertriglyceridemia. Management varied among the cases but included: NPO or very-low-fat diet, insulin, intravenous fluids, fibrates, and omega-3 fatty acids.
Conclusions
These cases suggest that pediatric severe hypertriglyceridemia management, in the absence of pancreatitis should allow a very-low-fat diet initially rather than NPO followed by pharmacologic therapies.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from the families of living children included in this study.
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Ethical approval: The manuscript was reviewed and approved by the respective Research Ethics Board (REB).
References
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Articles in the same Issue
- Frontmatter
- Reviews
- Artificial Intelligence (AI) in pediatric endocrinology
- Relationship between vitamin D deficiency and neonatal hypocalcemia: a meta-analysis
- Original Articles
- Associated autoimmune thyroid diseases in children and adolescents with type one diabetes in Jordan
- The therapeutic effect of oral desmopressin lyophilisate formulation in children with central diabetes insipidus
- Effect of complete suppression of androstenedione on auxological development in prepubertal patients with classical congenital adrenal hyperplasia
- Safety and efficacy of the structured onboarding steps and initiation protocol for MiniMed™ 780G system among an Egyptian cohort of young people living with type 1 diabetes
- The effect of problem-solving skills on blood glucose regulation and disease management in children with type 1 diabetes mellitus
- Depression, anxiety, eating problems, and diabulimia risk in adolescents with type 1 diabetes: a case–control study
- Genotyping in patients with congenital adrenal hyperplasia by sequencing of newborn bloodspot samples
- Case Reports
- A pediatric case of autosomal dominant hypocalcemia type 2
- Very severe hypertriglyceridemia complicating pediatric acute lymphoblastic leukemia treatment: a call for management guidelines
- Management of acute metabolic crisis in TANGO2 deficiency: a case report
- Novel PAX4 variant in a child and family with diabetes mellitus – case report and review of the literature
- Graves’ disease after COVID mRNA vaccination for the first time diagnosed in adolescence-case report. Cause and effect relationship or simple coincidence?
