Triglyceride Levels Greater Than 10,000 mg/dL in a 49-Year-Old Female without Evidence of Pancreatitis

Table 2

Fredrickson classification of primary hypertriglyceridemia [6, 8].

TYPE	ELEVATED LIPOPROTEIN	LIPID PROFILE	CLINICAL MANIFESTATIONS	RELATIVE FREQUENCY
I – Familial chylomicronemia	Chylomicron	TC +; TG +++	Presents in infancy, eruptive xanthomas, recurrent pancreatitis, failure to thrive	<1%
II b – Familial Combined Hyperlipidemia	LDL, VLDL, Apo-B	TC ++; TG ++	Xanthomas less common. Risk of premature CVD	40%
III – Familial dysbetalipoproteinemia	IDL	TC ++; TG ++	Palmar xanthomas, risk of premature CVD	<1%
IV – Familial Hypertriglyceridemia	VLDL	TC +; TG ++	Associated w/ DM, insulin resistance, obesity, HTN	45%
V – Primary Mixed Hyperlipidemia	Chylomicron, VLDL	TC +++; TG +++	Similar to type I but develops in adulthood	5%

TC = total cholesterol; TG = triglycerides; DM = Diabetes Mellitus; HTN = Hypertension; CVD = cardiovascular disease; LDL = low-density lipoprotein; VLDL = very low-density lipoprotein; IDL = intermediate density lipoprotein; Apo-B = apolipoprotein B.