Asymptomatic severe dyslipidemia in a middle aged man: a case report

Abstract

We describe case of nonobese, North Indian man involved in daily moderate to vigorous activity, who presented for routine biochemical profile. On centrifugation blood was found to be highly lipemic and lipid profile was grossly deranged. He had combined hyperlipidemia with predominant hypertriglyceridemia, highly raised apolipoprotein B and uric acid. The patient was further evaluated, started on combination therapy with statins and fibrates and followed weekly for next six weeks. Only a positive dietary history of high carbohydrate and fat intake could be elucidated. At baseline, total cholesterol was 789 mg/dl and serum triglycerides were 2400 mg/dl. His uric acid and apolipoprotein B levels were 11.1 mg/dl and 697 mg/dl respectively. The patient remained asymptomatic throughout the follow-up and showed a dramatic improvement in uric acid levels and lipid profile including Apolipoprotein B. In rare cases like the present one, massive hypertriglyceridemia may remain silent over many years without any clinical presentation.