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Hepatomegaly
Hepatomegaly


Chylomicronemia syndrome

Definition:

Chylomicronemia syndrome is a disorder passed down through families in which the body does not break down fats (lipids) correctly. This causes a type of fats called chylomicrons to build up in the blood.



Alternative Names:

Familial lipoprotein lipase deficiency



Causes, incidence, and risk factors:

Chylomicronemia syndrome is a rare genetic disorder. It occurs when a protein (enzyme) called lipoprotein lipase (LpL) is broken or missing. LpL is normally found in fat and muscle and helps break down certain lipids. When LpL is missing or broken, chylomicrons build up in the blood. This is called chylomicronemia.



Symptoms:

Symptoms may start in infancy and include:

  • Abdominal pain due to pancreatitis (inflammation of the pancreas)
  • Deposits of slightly discolored tissue on the eyelids


Signs and tests:

Examination and tests may show an enlarged liver and spleen, inflammation of the pancreas, fatty deposits under the skin, and possibly deposits in the retina of the eye.

A layer of cream due to chylomicrons will appear when blood spins in a laboratory machine. The triglyceride level is extremely high.



Treatment:

A completely fat-free diet is required.



Support Groups:



Expectations (prognosis):

Symptoms tend to be dramatically reduced when patients adhere to a fat-free diet.



Complications:

When untreated, the excess chylomicrons may lead to bouts of pancreatitis, which can be extremely painful. There seems to be no increased risk for atherosclerotic heart disease.



Calling your health care provider:

Call your health care provider if you have any of the symptoms associated with this syndrome and you have not had your blood triglyceride levels measured, or if you are due for a routine physical examination.



Prevention:

There is no way to prevent this syndrome, but sticking to a fat-free diet can prevent its symptoms.



References:

Benlian P, De Gennes JL, Foubert L, Zhang H, Gagne SE, Hayden M. Premature atherosclerosis in patients with familial chylomicronemia caused by mutations in the lipoprotein lipase gene. N Engl J Med. 1997;336(14):1026-1027.




Review Date: 1/23/2008
Reviewed By: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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