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Year : 2021  |  Volume : 10  |  Issue : 2  |  Page : 135-137

A case of milky serum in neonate with rare mutation of lipoprotein lipase

Department of Paediatrics, Government Raja Mirasudhar Hospital, Thanjavur Medical College, Thanjavur, Tamil Nadu, India

Correspondence Address:
R Peter
S/O Ramu, Assistant Professor, Neonatology, Thanjavur Medical College, Thanjavur, Tamil Nadu; 1340, Kamban Nagar, Pudukottai - 622 003, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcn.jcn_129_20

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Acute pancreatitis is one of the dreaded complications of hypertriglyceridemia. According to the literature, 7% of cases of acute pancreatitis are due to hypertriglyceridemia or chylomicronemia associated with genetic defects in the lipid metabolism. Here, we report a 17-day-old baby, who presented as a case of necrotizing enterocolitis. Incidental phlebotomy showed pink creamy serum. This highly suggestive of hypertriglyceridemia, lipid profile study was done that confirmed elevated serum triglyceride (TG) and cholesterol levels with decreased high-density lipoprotein. To minimize the risk of pancreatitis, exchange transfusion, a procedure widely performed in neonatology was sought to, that dramatically reduced the serum TG and cholesterol levels. Baby was then started on skimmed milk, fenofibrate, and medium-chain TGs oil to maintain the plasma TG levels low. Genetic analysis confirmed the diagnosis of type I hyperlipoproteinemia/familial combined hyperlipidemia-3. This report emphasizes the importance of suspecting hypertriglyceridemia on witnessing milky serum so that early intervention with novel modalities such as exchange transfusion can prevent complications such as acute pancreatitis.

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