Severe Hyperlipidemia after Stem Cell Transplantation
Keywords:
Hyperlipidemia, Stem cell transplantation, Diabetes mellitus, Hypothyroidism, CyclosporinAbstract
Abstract : A 14-year-old Thai-muslim boy underwent matched-sibling peripheral blood stem cell transplantation for acute lymphoblastic leukemia in second complete remission. He had severe graft versus host disease after transplantation and was controlled with cyclosporin and high-dose oral prednisolone. Seven months after the transplantation, he developed diabetic ketoacidosis and severe hyperlipidemia. The serum triglyceride and cholesterol were 8,510 and 1,111 mg/dL respectively.
Hypothyroidism with free T4 0.44ng/dL (0.70-1.75) and TSH (IRMA) 0.35 mIU/L (0.25-4.00) was diagnosed as well. The treatment included regular insulin injection, thyroid hormone replacement and step-down dosage of cyclosporin and prednisolone. The serum lipid levels decreased rapidly 5 days later, the serum triglyceride and cholesterol was 234 and 726 mg/dL respectively. Severe hyperlipidemia is a possible complication in complicated cases of stem cell transplant patients, especially those with diabetes mellitus and hypothyroidism. Cyclosporin may take part in inducing hyperlipidemia.
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