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Severe hypertriglyceridemia — ABIM Board MCQ

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HardEndocrinology/MetabolismSevere hypertriglyceridemiaABIM Board

A 42-year-old man has recurrent pancreatitis. Fasting triglycerides are 1,320 mg/dL, LDL cholesterol is 94 mg/dL, A1c is 8.7%, and TSH is normal. He drinks minimal alcohol. Which of the following is the most appropriate management to reduce pancreatitis risk?

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Correct answer: C — High-dose omega-3 or fibrate therapy with diabetes optimization and dietary fat restriction

Severe hypertriglyceridemia, especially above 1000 mg/dL with pancreatitis, is treated with strict dietary fat reduction, secondary-cause control such as diabetes management, and triglyceride-lowering therapy such as fibrate or high-dose omega-3 fatty acids.

Reference: Endocrine Society Hypertriglyceridemia Guideline; ACC Lipid Guidance