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Zsíros et al. Vessel Plus 2019;3:6 Vessel Plus
DOI: 10.20517/2574-1209.2018.78

Case Report Open Access

Successful plasmapheresis treatment of severe
hypertriglyceridemia during late pregnancy

Noémi Zsíros, Beáta Kovács, György Paragh, József Balla, Mariann Harangi

Department of Internal Medicine, University of Debrecen Faculty of Medicine, Debrecen H-4032, Hungary.

Correspondence to: Dr. Mariann Harangi, Department of Internal Medicine, University of Debrecen Faculty of Medicine,
Nagyerdei Blvd. 98, Debrecen H-4032, Hungary. E-mail: mharangi@hotmail.com

How to cite this article: Zsíros N, Kovács B, Paragh G, Balla J, Harangi M. Successful plasmapheresis treatment of severe
hypertriglyceridemia during late pregnancy. Vessel Plus 2019;3:6. http://dx.doi.org/10.20517/2574-1209.2018.78

Received: 11 Dec 2018 First Decision: 15 Jan 2019 Revised: 22 Jan 2019 Accepted: 23 Jan 2019 Published: 19 Mar 2019
Science Editor: Alexander N. Orekhov Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
During pregnancy, physiologic hormonal changes provoke a significant increase in triglyceride levels. Genetic
abnormalities of triglyceride metabolism and secondary factors may multiply the risk of severe lipid abnormalities.
Although severe gestational hypertriglyceridemia can be a life-threatening condition for both mother and fetus, its
optimal treatment has not been fully clarified. A 33-year-old woman at 37 weeks of her second pregnancy was admitted
to our clinic. Her triglyceride level was 57.8 mmol/L. Abdominal pain, nausea, vomiting or any other complaints were
not reported. She kept a fat-restricted diet, however her triglyceride level remained 41 mmol/L. Therefore we decided to
perform plasmapheresis with a replacement of human albumin as a colloidal solution. Complications did not occur during
the treatment. Plasmapheresis reduced her triglyceride level by 54.1% (to 18.8 mmol/L), and the patient delivered a
healthy female neonate at 40 weeks. In case of significantly increased values, plasmapheresis is a fast, effective and safe
method for decreasing triglyceride level even in the third trimester.

Keywords: Hypertriglyceridemia, pregnancy, plasmapheresis

INTRODUCTION
Maternal lipids are extremely important for developing a fetus. While cholesterol is a crucial molecule
in placental steroid synthesis, fatty acids participate in placental oxidation processes and membrane
[1]
development . In pregnant women, significant alterations in lipid levels are in connection with estrogen,
[2]
progesterone and human placental lactogen synthesis . During normal pregnancy, increased lipolytic
activity raises the release of free fatty acid and the production of very low-density lipoprotein (VLDL).

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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