A young infant with transient severe hypertriglyceridemia temporarily associated with meropenem administration: A case report and review of the literature

Susanna Esposito, Raffaella Pinzani, Genny Raffaeli, Tiziano Lucchi, Carlo Agostoni, Nicola Principi

Research output: Contribution to journalArticle

Abstract

Background: Slight changes in the lipid profile can be observed over the acute phase of infectious diseases. Moreover, some antiinfective drugs can modify serum lipid concentrations, although antibiotics do not seem to have a relevant, direct, or acute effect on the lipid profile. Methods:A 75-day-old breastfed Caucasian female, born at term after a regular pregnancy, was hospitalized for osteomyelitis. She was immediately treated with intravenous meropenem and vancomycin. Therapy was effective, but after 22 days of treatment, her blood was found to be viscous with a purple shade. Results: A fasting blood sample showed serum triglycerides of 966mg/dL, total cholesterol of 258mg/dL, and high-density lipoprotein cholesterol of 15mg/dL. Secondary causes of hyperlipidemia and primary hereditary disorders were ruled out. Thereafter, the possibility that antibiotics may have had a role in the hypertriglyceridemia was considered, and meropenem was discontinued. After 72 hours of meropenem discontinuation, a sharp modification of lipid variables was observed, and further testing showed a complete normalization of the lipid profile. Conclusion: In this child with osteomyelitis, the increase in serum triglycerides appeared suddenly after 3 weeks of meropenem treatment and resolved quickly after meropenem discontinuation, thus highlighting the possible association between meropenem and lipid profile alterations. Monitoring the lipid profile should be considered in cases of long-term treatment with meropenem, and further studies on meropenem safety should include evaluation of the lipid profile.

Original languageEnglish
Article numbere4872
JournalMedicine (United States)
Volume95
Issue number38
DOIs
Publication statusPublished - 2016

Fingerprint

meropenem
Hypertriglyceridemia
Lipids
Osteomyelitis
Triglycerides
Serum
Anti-Bacterial Agents
Vancomycin
Therapeutics
Hyperlipidemias
HDL Cholesterol

Keywords

  • Antibiotics
  • Hyperlipidemia
  • Hypertriglyceridemia
  • Meropenem
  • Osteomyelitis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "A young infant with transient severe hypertriglyceridemia temporarily associated with meropenem administration: A case report and review of the literature",
abstract = "Background: Slight changes in the lipid profile can be observed over the acute phase of infectious diseases. Moreover, some antiinfective drugs can modify serum lipid concentrations, although antibiotics do not seem to have a relevant, direct, or acute effect on the lipid profile. Methods:A 75-day-old breastfed Caucasian female, born at term after a regular pregnancy, was hospitalized for osteomyelitis. She was immediately treated with intravenous meropenem and vancomycin. Therapy was effective, but after 22 days of treatment, her blood was found to be viscous with a purple shade. Results: A fasting blood sample showed serum triglycerides of 966mg/dL, total cholesterol of 258mg/dL, and high-density lipoprotein cholesterol of 15mg/dL. Secondary causes of hyperlipidemia and primary hereditary disorders were ruled out. Thereafter, the possibility that antibiotics may have had a role in the hypertriglyceridemia was considered, and meropenem was discontinued. After 72 hours of meropenem discontinuation, a sharp modification of lipid variables was observed, and further testing showed a complete normalization of the lipid profile. Conclusion: In this child with osteomyelitis, the increase in serum triglycerides appeared suddenly after 3 weeks of meropenem treatment and resolved quickly after meropenem discontinuation, thus highlighting the possible association between meropenem and lipid profile alterations. Monitoring the lipid profile should be considered in cases of long-term treatment with meropenem, and further studies on meropenem safety should include evaluation of the lipid profile.",
keywords = "Antibiotics, Hyperlipidemia, Hypertriglyceridemia, Meropenem, Osteomyelitis",
author = "Susanna Esposito and Raffaella Pinzani and Genny Raffaeli and Tiziano Lucchi and Carlo Agostoni and Nicola Principi",
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T1 - A young infant with transient severe hypertriglyceridemia temporarily associated with meropenem administration

T2 - A case report and review of the literature

AU - Esposito, Susanna

AU - Pinzani, Raffaella

AU - Raffaeli, Genny

AU - Lucchi, Tiziano

AU - Agostoni, Carlo

AU - Principi, Nicola

PY - 2016

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N2 - Background: Slight changes in the lipid profile can be observed over the acute phase of infectious diseases. Moreover, some antiinfective drugs can modify serum lipid concentrations, although antibiotics do not seem to have a relevant, direct, or acute effect on the lipid profile. Methods:A 75-day-old breastfed Caucasian female, born at term after a regular pregnancy, was hospitalized for osteomyelitis. She was immediately treated with intravenous meropenem and vancomycin. Therapy was effective, but after 22 days of treatment, her blood was found to be viscous with a purple shade. Results: A fasting blood sample showed serum triglycerides of 966mg/dL, total cholesterol of 258mg/dL, and high-density lipoprotein cholesterol of 15mg/dL. Secondary causes of hyperlipidemia and primary hereditary disorders were ruled out. Thereafter, the possibility that antibiotics may have had a role in the hypertriglyceridemia was considered, and meropenem was discontinued. After 72 hours of meropenem discontinuation, a sharp modification of lipid variables was observed, and further testing showed a complete normalization of the lipid profile. Conclusion: In this child with osteomyelitis, the increase in serum triglycerides appeared suddenly after 3 weeks of meropenem treatment and resolved quickly after meropenem discontinuation, thus highlighting the possible association between meropenem and lipid profile alterations. Monitoring the lipid profile should be considered in cases of long-term treatment with meropenem, and further studies on meropenem safety should include evaluation of the lipid profile.

AB - Background: Slight changes in the lipid profile can be observed over the acute phase of infectious diseases. Moreover, some antiinfective drugs can modify serum lipid concentrations, although antibiotics do not seem to have a relevant, direct, or acute effect on the lipid profile. Methods:A 75-day-old breastfed Caucasian female, born at term after a regular pregnancy, was hospitalized for osteomyelitis. She was immediately treated with intravenous meropenem and vancomycin. Therapy was effective, but after 22 days of treatment, her blood was found to be viscous with a purple shade. Results: A fasting blood sample showed serum triglycerides of 966mg/dL, total cholesterol of 258mg/dL, and high-density lipoprotein cholesterol of 15mg/dL. Secondary causes of hyperlipidemia and primary hereditary disorders were ruled out. Thereafter, the possibility that antibiotics may have had a role in the hypertriglyceridemia was considered, and meropenem was discontinued. After 72 hours of meropenem discontinuation, a sharp modification of lipid variables was observed, and further testing showed a complete normalization of the lipid profile. Conclusion: In this child with osteomyelitis, the increase in serum triglycerides appeared suddenly after 3 weeks of meropenem treatment and resolved quickly after meropenem discontinuation, thus highlighting the possible association between meropenem and lipid profile alterations. Monitoring the lipid profile should be considered in cases of long-term treatment with meropenem, and further studies on meropenem safety should include evaluation of the lipid profile.

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KW - Osteomyelitis

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