A CASE REPORT OF PROFOUND HYPERTRIGLYCERIDAEMIA (51 MMOL/L) FOLLOWING CHEMOTHERAPY FOR POST-TRANSPLANT LYMPHOPROLIFERATIVE DISEASE IN A KIDNEY TRANSPLANT RECIPIENT.
Dr CAMERON BURNETT1, Dr BRIAN DOUCET2, Dr KIRK MORRIS3, Dr GEORGE JOHN2
1Kidney Health Service, Royal Brisbane and Women’s Hospital, Brisbane, Australia, 2School of Clinical Medicine, The University of Queensland, Brisbane, Australia, 3Haematology Services, Royal Brisbane and Women’s Hospital, Brisbane, Australia
There is growing interest in the mechanism and treatment of elevated cholesterol levels that may occur during the use of drugs post kidney transplantation, including inhibitors of the mamallian target of rapamycin (mTOR; sirolimus, everolimus) and platinum-based chemotherapy for the treatment of cancers including post-transplant lymphoproliferative disease (PTLD). Kidney transplant recipients are at increased risk of malignancy including PTLD and are a population not uncommonly exposed to one or both classes of these pharmaceuticals during their lifetime. Yet, these patients are simultaneously at high cardiovascular risk and inadequate cholesterol and triglyceride regulation increases their morbidity and mortality. Very severe hypertriglyceridaemia is defined as >22.6 mmol/L. Here we describe a case of a 41-year-old man, 13 years post kidney transplantation, presenting with a triglyceride level of 51 mmol/L following platinum-based chemotherapy for high-risk PTLD requiring cessation of treatment and subsequent palliation in the context of the patients wish to withdraw from further treatment. We define and contextualise the case with a narrative review of cholesterol dysregulation in mTOR inhibition and platinum-based chemotherapy, and discuss unique management considerations for this case.
Biography:
Dr Cameron Burnett is a Kidney Advanced Trainee at the RBWH, Queensland. Dr Burnett is a clinician-researcher presently involved in glomerulonephritis, peritoneal dialysis, quality of life in patients with CKD and interventional nephrology. He is pursuing a PhD at the University of Queensland in Life Participation outcome measure validation and strategies to improve life goal attainment in patients with CKD. He is completing a Masters of Public health in Healthcare Redesign and is interested in educational reform. He graduated from the University of Tasmania in 2016 with 1st Class Hons with Scholarship, Clinical Distinction and RACP prize (Internal Medicine). He enjoys free time with his beautiful wife and two daughters.