BİR HİPERTRİGLİSERİDEMİ BULGUSU: ERÜPTİF KSANTOM
Erüptif ksantomlar, ekstremitelerin ekstansör yüzlerinde bulunan ve sıklıkla hipertrigliseridemi ve/veya kontrolsüz diyabet ile ilişkili iyi huylu lezyonlardır. Bu olgu sunumunda hipertrigliseridemi, tip 2 diyabet ve erüptif ksantomları olan ve tedaviden sonra tamamen iyileşen bir hastayı sunuyoruz. 37 yaşında erkek hasta, dirseklerinde kırmızımsı sarı renkli lezyonlar ile kliniğimize başvurdu. Vücut kitle indeksi 30 kg/m2 ve laboratuvar sonuçlarında yüksek trigliserid ve glukoz seviyeleri (trigliserid 6548 mg/dL, glukoz 245 mg/dL) ile birlikte hemoglobin A1c % 11.2 idi. Erüptif ksantomlar iyi huylu olmalarına rağmen, genellikle ömür boyu tedavi gerektiren hastalıklarla ilişkilidirler.
ERUPTIVE XANTHOMA: A MARKER OF HYPERTRIGLYCERIDEMIA
Eruptive xanthomas are benign lesions which are found in extensor surfaces of the extremities and are often associated with hypertriglyceridemia and/or uncontrolled diabetes. In this case report, we present a patient with hypertriglyceridemia, type 2 diabetes mellitus and eruptive xanthomas who recovers fully after treatment. A 37-year-old male patient presented to our clinic with reddish yellow lesions on his elbows. His body mass index was 30 kg/m2 and his laboratory results showed high serum triglyceride and glucose levels (triglyceride 6548 mg/dL, glucose 245 mg/dL), his hemoglobin A1c was 11.2%. Although eruptive xanthomas have a benign nature, they are associated with disease which often need lifelong treatment.
___
- 1. Hsueh YC, Chou CL, Lee TI. Diabetic dyslipidemia with eruptive xanthoma. Cleve Clin J Med 2019;86(9):575. [CrossRef]
- 2. Muhammad Kashif, Hanesh Kumar, Misbahuddin K. An unusual presentation of eruptive xanthoma A case report and literature review. Medicine (Baltimore) 2016;95(37):e4866. [CrossRef]
- 3. Zak A, Zeman M, Slaby A, Vecka M. Xanthomas: clinical and pathophysiological relations. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014;158(2):181-8. [CrossRef]
- 4. Kala J, Mostow EN. Eruptive xanthoma. N Engl J Med 2012;366(9):835. [CrossRef] 5. Streit E, Helmbold P. 65-year-old man with yellow-orange papules on both forearms. Eruptive xanthomas. Hautarzt 2009;60(10):834-7. [CrossRef]
- 6. Mangili LC, Miname MH, Silva PRS, Bittencourt MS, Rocha VZ, Mangili OC, et al. Achilles tendon xanthomas are associated withthe presence and burden of subclinical coronary atherosclerosis inheterozygous familial hypercholesterolemia: A pilot study. Atherosclerosis 2017;263:393-7. [CrossRef]
- 7. Lee SY, Sheth CA. Eruptive xanthoma associated with severe hypertriglyceridemia and poorly controlled type 1 diabetes mellitus. J Community Hosp Intern Med Perspect 2019;9(4):344-6. [CrossRef]
- 8. Christoffersen M, Frikke-Schmidt R, Schnohr P, Jensen GB, Nordestgaard BG, Tybjærg-Hansen A. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study. BMJ 2011;343:d5497. [CrossRef]
- 9. Duzayak S, Sayiner ZA, Erkılıç S, Inaloz HS. Acute pancreatitis with eruptive xanthoma. BMJ case reports. 2017;2017:bcr2017221543. [CrossRef]
- 10. Fredrickson DS. An international classification of hyperlipidemias and hyperlipoproteinemias. Ann Intern Med 1971;75(3):471-2. [CrossRef]
- 11. Cnop M. Fatty acids and glucolipotoxicity in the pathogenesis of Type 2 diabetes. Biochem Soc Trans 2008;36(Pt 3):348-52. [CrossRef]
- 12. Shimabukuro M, Ohneda M, Lee Y. Unger, RH. Role of nitric oxide in obesity induced β-cell disease. J Clin Invest 1997;100(2):290-5. [CrossRef]
- 13. Alagözlü H, Cindoruk M, Karakan T. Ünal S. Heparin and insulin in the treatment of hypertriglyceridemia-induced severe acute pancreatitis. Dig Dis Sci 2006;51(5):931-3. [CrossRef]
- 14. Ewald N, Kloer HU. Treatment options for severe hypertriglyceridemia (SHTG): the role of apheresis. Clin Res Cardiol Suppl 2012;7(Suppl 1):31-5. [CrossRef]
- 15. Joseph L Witztum, D Gaudet, Steven D Freedman et al. Volanesorsen and Triglyceride Levels in Familial Chylomicronemia Syndrome. N Engl J Med. 2019;381(6):531- 42. [CrossRef]