gestodene and Pancreatitis

Hypertriglyceridemia is the third most common cause of acute pancreatitis. Among the causes that lead to secondary hypertriglyceridemia, the use of contraceptive agents is the main reason to be assessed in young women. We report a case of a 31-year-old woman who had suffered two acute pancreatitis episodes secondary to hypertriglyceridemia. In the investigation, the previous medical team indicated a genetic screening before ruling out all secondary causes. LPL, apo CII and apo AV genes were negative for mutations. In the first appointment with us, the patient reported the use of a contraceptive agent for about 2 years. She was instructed to discontinue the drug. After one year of follow-up, her serum triglycerides are within the normal range and a copper intrauterine device was the method chosen by the patient for contraception.. 摘要 高甘油三酯血症是引起急性胰腺炎的第三大常见病因。而使用避孕药是导致年轻女性继发高甘油三酯血症的主要原因。本例病例报道如下：女性, 31岁, 出现两次继发于高甘油三酯血症的急性胰腺炎发作。在调查中, 先前的医疗小组在排除所有继发原因之前对患者进行了基因筛查, 其中LPL、apo CII和apo AV基因对突变呈阴性。患者自述已服用避孕药约2年。在指导患者停止服药随访一年后, 患者的血清甘油三酯水平降至正常范围内, 而且含铜宫内节育器是这类服用避孕药患者可选择的避孕方法。.

Topics: Adult; Contraceptives, Oral, Synthetic; Estrogens; Ethinyl Estradiol; Humans; Hypertriglyceridemia; Norpregnenes; Pancreatitis

A now 24-year-old woman was found at the age of 2 years to have an hyperchylomicronaemia syndrome due to lipoprotein lipase deficiency: the triglyceride level was then 6000 mg/dl. But in subsequent years it had been reduced to between 550 and 2600 mg/dl by dieting. There were no xanthomas or abdominal symptoms during those years. When aged 20 years she was put on oral contraceptives (one-phase preparation: 0.03 mg ethinylestradiol and 0.075 gestodene). Six months later she had the first attack of severe necrotizing pancreatitis; three more attacks followed in the subsequent 6 months. All four attacks occurred during the drug-free period of the menstrual cycle. The relationship with contraceptive intake was not established until the fourth attack. The last acute pancreatitis (lipase 3283 U/l amylase 595 U/l, triglyceride 2400 mg/dl, WBC count 13,899/microliters; ultrasonography revealed fluid swelling and necrotic areas, especially around the splenic hilus) regressed within 5 days and has not recurred for 3 years after the patient stopped taking oral contraceptives. On a diet the triglyceride level has been around 880 mg/dl.

Topics: Acute Disease; Adult; Contraceptives, Oral; Ethinyl Estradiol; Female; Humans; Hyperlipoproteinemia Type I; Necrosis; Norpregnenes; Pancreatitis; Triglycerides