Eruptif Ksantomla Ortaya Çıkan Tip 2 Diabetes Mellitus ve Obeziteli Bir Ağır Hipertrigliseridemi Olgusu

Yıl 2018, Cilt: 2 Sayı: 3, 125 - 128, 28.12.2018

Nursel DEVECİ ÇAKMAK Ayşe ALPAGUT İhsan AYHAN Rafet KOCA Taner BAYRAKTAROĞLU

Öz

Hipertrigliseridemi,
obezite ve hipotiroidizm gibi sekonder nedenler haricinde genetik lipid
bozuklukları şeklinde ortaya çıkmaktadır. Farklı klinik prezantasyonları
bulunmasına rağmen erişkin dönemde nadiren eruptif ksantom bulgusuyla
hipertrigliseridemi olguları tanı alır. Burada, şizofreni tanısıyla izlenirken
ciltte döküntüleriyle birlikte diabetes mellitus ve tip 5 hiper
trigliseridemisi tanısı alan bir olguyu sunmaktayız.

Anahtar Kelimeler

Eruptif Ksantom, Hiperlipidemi, Hipertrigliseridemi, Obezite, Diabetes Mellitus, Şizofreni, antipsikotikler

A Case of Severe Hypertrigliseridemia Presentation with Eruptive Xantoma in an Adult with Type-2 Diabetes Mellitus and Obesity

Öz

Hypertriglyceridemia occurs as genetic lipid disorders with the exception of secondary causes such as obesity and hypothyroidism. Although there are different clinical presentations, hypertriglyceridemia cases are rarely seen in adulthood with the presence of eruptive xanthoma. Here, we present a case with schizophrenia diagnosed with skin rashes and diabetes mellitus and severe hypertriglyceridemia. As seen in our case, hyperlipidemias may occur with obesity, diabetes mellitus and antipsychotics in individuals with genetic background. Their presentation may be in the form of eruptive xanthomas, a rare finding. In such cases, effective results can be obtained with a multifaceted approach to metabolic pathways without requiring lipid apheresis.

Anahtar Kelimeler

Eruptive Xanthoma, Hyperlipidemia, Hypertriglyceridemia, Obesity, Diabetes Mellitus, Schizophrenia, Antipsychotics

Kaynakça

• Kushner PA, Cobble ME.Hypertriglyceridemia: the importance of identifying patients at risk. Postgrad Med. 2016;128(8):848-858.
• Fredrickson DS, Lee RS. A system for phenotyping hyperlipidemia. Circulation 1965;31:321-7.
• Ginsberg Hn. Diabetic Dyslipidemia: Basic Mechanisms Underlying The Common Hypertriglyceridemia And Low Hdl Cholesterol Levels. Diabetes. 1996; 45(Suppl 3):S27–S30.
• Zaremba J. Zackiewicz A, Placek W. Eruptive xanthomas. Postep Derm Alergol 2013;30(6):399-402.
• Bito T, Kawakami C, Shimajiri S, Tokura Y. Generalized eruptive xanthoma with prominent deposition of naked chylomicrons: evidence for chylomicrons as the origin of urate-like crystals. J Cutan Pathol. 2010;37:1161-3.
• Henning JS, Fazio MG. Yellowish papules on a middle-aged man. Eruptive xanthoma. Am Fam Physician. 2011;83:73-4.
• Ladizinski B, Lee KC. Eruptive xanthomas in a patient with severe hypertriglyceridemia and type 2 diabetes. CMAJ. 2013;185:1600.
• Vangara SS, Klingbeil KD, Fertig RM, Radick JL. Severe hypertriglyceridemia presenting as eruptive xanthomatosis. J Family Med Prim Care. 2018;7(1):267-270.
• Kayaalp O. Hipolipidemik İlaçlar: Kayaalp O, ed. Rasyonel Tedavi Yönünden Tıbbi Farmakoloji. Ankara, Hacettepe TAŞ Kitapçılık Ltd Şti, 2000: 1. cilt, 8.baskı, 567- 587.
• Hegele RA, Ginsberg HN, Chapman MJ, Nordestgaard BG, Kuivenhoven JA, Averna M, et al. The polygenic nature of hypertriglyceridaemia: Implications for definition, diagnosis, and management. Lancet Diabetes Endocrinol. 2014;2:655–66.
• Valdivielso P, Ramírez-Bueno A, Ewald N. Current knowledge of hypertriglyceridemic pancreatitis. Eur J Intern Med. 2014;25:689–94