[Pseudohiponatremia secondary to hypertriglyceridemia during the treatment of lymphoblastic lymphoma with corticoids and L-asparaginase].

Abstract

L-asparaginase (L-asp) is an antineoplastic drug used in Leukemia and Lymphoma treatment protocols. Alterations in lipid metabolism have been reported in 10-50% of children treated with L-Asp.

Objective: To report an unusual complication of lipid metabolism associated with the use of L-Asp.

Clinical case: We describe the clinical picture of an adolescent who, during treatment for Lymphoblastic Non-Hodgkin Lymphoma (NHL), presented pseudohyponatremia and hypertriglyceridemia, suspecting an adverse drug reaction (ADR). This suspicion was evaluated according to the modified causality algorithm (Karch and Lasagna), resulting in a "definitive" ADR for the L-asparaginase and corticosteroids association. He received treatment with a low-fat diet and lipid-modifying drugs; L-asparaginase and prednisone were not suspended since the protocol ended. Hypertriglyceridemia recovered without complications after 14 days of treatment.

Conclusion: Although the magnitude of the hypertriglyceridemia did not result in clinical pancreatitis, it seems advisable to include ADR suspicion to L-asp among the differential diagnoses, to highlight the need to detect these complications, and to know their prognosis and management in order not to affect the treatment of the patients.