Clinical Drug Investigation

, Volume 26, Issue 5, pp 297–302 | Cite as

Tamoxifen-Induced Severe Hypertriglyceridaemia and Acute Pancreatitis

  • Hakan AlagozluEmail author
  • Mehmet Cindoruk
  • Selahattin Unal
Case Report


Hypertriglyceridaemia is a well known risk factor for acute pancreatitis. Hypertriglyceridaemia may be primary in origin or secondary to alcohol abuse, diabetes mellitus, pregnancy or use of drugs. In this case report, the cause of acute pancreatitis was tamoxifen. We report on a patient with tamoxifen-induced acute pancreatitis and hypertriglyceridaemia who was successfully treated with insulin infusion and long-term gemfibrozil.


Pancreatitis Tamoxifen Amylase Acute Pancreatitis Acarbose 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors received no funding for this report, and have no conflicts of interest directly relevant to the content of this report.


  1. 1.
    Shapiro CL, Recht A. Side effects of adjuvant treatment of breast cancer. N Engl J Med 2001; 344: 1997–2008PubMedCrossRefGoogle Scholar
  2. 2.
    Osborne CK. Tamoxifen in the treatment of breast cancer. N Engl J Med 1998; 339: 1609–18PubMedCrossRefGoogle Scholar
  3. 3.
    Hozumi Y, Kawano M, Saito T, et al. Effect of tamoxifen on serum lipid metabolism. J Clin Endocrinol Metab 1998; 83: 1633–5PubMedCrossRefGoogle Scholar
  4. 4.
    Koshizuka K, Serizawa M, Hasuda N, et al. Tamoxifen-induced severe hypertriglyceridemia: report of 3 cases. Gan To Kagaku Ryoho 2004; 31(7): 1109–12PubMedGoogle Scholar
  5. 5.
    Liu CL, Yang TL. Sequential changes in serum triglyceride levels during adjuvant tamoxifen therapy in breast cancer patients and the effect of dose reduction. Breast Cancer Res Treat 2003; 79(1): 11–6PubMedCrossRefGoogle Scholar
  6. 6.
    Artac M, Sari R, Altunbas H, et al. Asymptomatic acute pancreatitis due to tamoxifen-induced severe hypertriglyceridemia in a patient with diabetes mellitus and breast cancer. J Chemother 2002 Jun; 14(3): 309–11PubMedGoogle Scholar
  7. 7.
    Noguchi M, Taniya T, Tajiri K, et al. Fatal hyperlipaemia in a case of metastatic breast cancer treated by tamoxifen. Br J Surg 1987; 74: 586–7PubMedCrossRefGoogle Scholar
  8. 8.
    Colls BM, George PM. Severe hypertriglyceridaemia and hypercholesterolaemia associated with tamoxifen use. Clin Oncol 1998; 10: 270–1CrossRefGoogle Scholar
  9. 9.
    Elisaf MS, Nakou K, Liamis G, et al. Tamoxifen-induced severe hypertriglyceridemia and pancreatitis. Ann Oncol 2000; 11: 1067–9PubMedCrossRefGoogle Scholar
  10. 10.
    Fan ST, Lai EC, Mok FP, et al. Prediction of the severity of acute pancreatitis. Am J Surg 1993; 166(3): 262–8PubMedCrossRefGoogle Scholar
  11. 11.
    Dimagno EP, Chari S: Acute pancreatitis. In: Feldman M, Friedman LS, Sleisenger MH, eds. Gastrointestinal and liver Disease: Pathophysiology/Diagnosis/Management 7th ed. WB Saunders Co, Philadelphia, 2002: 913–41Google Scholar
  12. 12.
    Toouli J, Brooke-Smith M, Bassi C, et al. Guidelines for the management of acute pancreatitis. J Gastroenterol Hepatol 2002; 17 Suppl: S15–39PubMedCrossRefGoogle Scholar
  13. 13.
    Hozumi Y, Kawano M, Miyata M. Severe hypertriglyceridemia caused by tamoxifen treatment after breast cancer surgery. Endocr J 1997; 44: 745–9PubMedCrossRefGoogle Scholar
  14. 14.
    Lin HH, Hsu CH, Chao YC. Tamoxifen-induced severe acute pancreatitis: a case report. Dig Dis Sci 2004; 49: 997–9PubMedCrossRefGoogle Scholar
  15. 15.
    Walsh BW, Schiff I, Rosner B, et al. Effects of postmenopausal estrogen replacement on the concentrations and metabolism of plasma lipoproteins. N Engl J Med 1991; 325: 1196–204PubMedCrossRefGoogle Scholar
  16. 16.
    Kanel KT, Wolmark N, Thompson PD. Delayed severe hypertriglyceridemia from tamoxifen. N Engl J Med 1997; 337: 281PubMedCrossRefGoogle Scholar
  17. 17.
    Bagdade JD, Wolter J, Subbaiah PV, et al. Effects of tamoxifen treatment on plasma lipids and lipoprotein lipid composition. J Clin Endocrinol Metab 1990; 70: 1132–5PubMedCrossRefGoogle Scholar
  18. 18.
    Brun LD, Gagne C, Rousseau C, et al. Severe lipemia induced by tamoxifen. Cancer 1986; 57: 2123–6PubMedCrossRefGoogle Scholar
  19. 19.
    Glueck CJ, Lang J, Hamer T, et al. Severe hypertriglyceridemia and pancreatitis when estrogen replacement therapy is given to hypertriglyceridemic women. J Lab Clin Med 1994; 123: 59–64PubMedGoogle Scholar
  20. 20.
    Mikhailidis DP, Ganotakis ES, Georgoulias VA, et al. Tamoxifen-induced hypertriglyceridaemia: seven case reports and suggestions for remedial action. Oncol Rep 1997; 4: 625–8PubMedGoogle Scholar
  21. 21.
    Milionis HJ, Liberopoulos EN, Elisaf MS. Tamoxifen-induced hypertriglyceridemia in association with diabetes mellitus Diabetes Metab 2001; 27 (2 Pt 1): 160–3PubMedGoogle Scholar
  22. 22.
    Henzen C, Rock M, Schnieper C, et al. Heparin and insulin in the treatment of acute hypertriglyceridemia-induced pancreatitis. Schweiz Med Wochenschr 1999; 129: 1242–8PubMedGoogle Scholar
  23. 23.
    Malmstrom R, Packard CJ, Caslake M, et al. Effects of insulin and acipimox on VLDL1 and VLDL2 apolipoprotein B production in normal subjects. Diabetes 1998; 47: 779–87PubMedCrossRefGoogle Scholar
  24. 24.
    Jabbar MA, Zuhri-Yafi MI, Larrea J. Insulin therapy for a non-diabetic patient with severe hypertriglyceridemia. J Am Coll Nutr 1998; 17: 458–61PubMedGoogle Scholar
  25. 25.
    Johnson SG, Ellis CJ, Levitt MD. Mechanism of increased renal clearance of amylase/creatinine in acute pancreatitis. N Engl J Med 1976; 295(22): 1214–7PubMedCrossRefGoogle Scholar
  26. 26.
    Sachdeva CK, Bank S, Greenberg R, et al. Fluctuations in serum amylase in patients with macroamylasemia. Am J Gastroenterol 1995; 90(5): 800–3PubMedGoogle Scholar
  27. 27.
    Yadav D, Nair S, Norkus EP, et al. Nonspecific hyperamylasemia and hyperlipasemia in diabetic ketoacidosis: incidence and correlation with biochemical abnormalities. Am J Gastroenterol 2000; 95(11): 3123–8PubMedCrossRefGoogle Scholar
  28. 28.
    Nair S, Yadav D, Pitchumoni CS. Association of diabetic ketoacidosis and acute pancreatitis: observations in 100 consecutive episodes of DKA. Am J Gastroenterol 2000; 95(10): 2795–800PubMedCrossRefGoogle Scholar
  29. 29.
    Lennertz A, Parhofer KG, Samtleben W, et al. Therapeutic plasma exchange in patients with chylomicronemia syndrome complicated by acute pancreatitis. Ther Apher 1999; 3: 227–33PubMedCrossRefGoogle Scholar
  30. 30.
    Jonkers GH. Tamoxifen and hypertriglyceridemia. Neth J Med 1999; 55(2): 84–5PubMedCrossRefGoogle Scholar
  31. 31.
    Taira M, Takasu N, Komiya I. Severe hypertriglyceridemia induced by tamoxifen. Nippon Ronen Igakkai Zasshi 1998; 35(11): 858–60PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2006

Authors and Affiliations

  • Hakan Alagozlu
    • 1
    Email author
  • Mehmet Cindoruk
    • 1
  • Selahattin Unal
    • 1
  1. 1.Department of Internal Medicine, Division of GastroenterologyMedical Faculty of Gazi UniversityAnkaraTurkey

Personalised recommendations