Abdominal Pain as the Manifestation of Chylomicronemia Syndrome During Pregnancy: A Challenging Diagnosis

Cureus. 2021 Apr 6;13(4):e14317. doi: 10.7759/cureus.14317.

Abstract

Hypertriglyceridemia is a frequent cause of acute pancreatitis. Levels higher than 1000 mg/dL are often associated with a genetic predisposition that can be aggravated by other factors such as pregnancy and poorly controlled diabetes. The authors report a 19-year-old primigravida that presented with abdominal pain, emesis and a pruritic rash, along with severely increased plasma triglyceride levels. Therapeutic plasmapheresis was proposed in the setting of a presumed acute pancreatitis. Chylomicronemia syndrome is a rare and frequently misdiagnosed pathology that can evolve with abdominal pain, vomiting and a specific cutaneous rash designated as eruptive xanthomatosis. This case report illustrates the challenges of achieving a correct diagnosis for rare conditions and corroborates the safety of plasmapheresis during pregnancy.

Keywords: abdominal pain; acute pancreatitis; atypical rash; chylomicrons; plasmapheresis; pregnancy; triglycerides.

Publication types

  • Case Reports