Background:
Hypertriglyceridemia (HTG) during pregnancy may be accompanied by
acute pancreatitis, hyperviscosity syndrome, and
preeclampsia. HTG during pregnancy should be managed by a multidisciplinary team; however, no clinical guidelines exist for severe gestational HTG. Case Presentation: We herein present a case of a 36-year-old in the first pregnancy (G1P0Ab0), with a history of severe HTG-induced necrotizing
pancreatitis 9 years earlier. There was no family history of HTG. During these years, she did not follow any appropriate diet or medical
therapy for HTG. She became pregnant in May 2019, without preconception counseling. Eruptive and tuberoeruptive
xanthomas appeared in the 27th week of pregnancy. Serum
triglycerides (TGs) and fasting
blood sugar (FBS) were 6,620 and 124 mg/dL, respectively, indicating HTG and
gestational diabetes (GDM). After admission for the management of severe HTG, she was put on
parenteral nutrition with
dextrose water 5% and infusion
insulin therapy without receiving any enteral
carbohydrate for 2 days. Following that, a very
low-fat diet and
omega-3 fatty acids (1,200 mg/day) were started. After 4 weeks, TG levels reached 1,000 mg/dL, and her self-monitoring blood glucose levels showed appropriate
blood glucose for pregnancy. She underwent a successful elective
cesarean section in the 39th of pregnancy. Conclusion: This case report demonstrates that HTG during pregnancy could be managed by
medical nutrition therapy (MNT).