SEVERE HYPERTRIGLYCERIDEMIA CAUSED BY TAMOXIFEN-TREATMENT AFTER BREAST-CANCER SURGERY

Tamoxifen, a nonsteroidal estrogen antagonist, has been widely used in a hormonal treatment for breast cancer. The side effects of tamoxifen are generally recognized to be mild. However, we experienced three ca ses of severe hypertriglyceridemia and/or hyperglycemia induced by tam oxifen. For normalization of their hypertriglyceridemia we need to sto p giving tamoxifen. In one of three cases we analyzed her lipoprotein profile in detail with lipoprotein lipase activities and apolipoprotei n E phenotype. The case was a 49 year-old woman. After 15 months of ta moxifen administration, she was diagnosed as severe hypertriglyceridem ia. Consecutively, severe hyperglycemia was occurred to need insulin t herapy. After tamoxifen withdrawal, her triglyceride and glucose level s improved. Her lipolytic enzyme was reduced during tamoxifen treatmen t. Apolipoprotein E phenotype was uncommon E4/2. Although hypertriglyc eridemia was not considered to be a risk factor for coronary heart dis ease, a marked hypertriglyceridemia might occasionally produce severe lethal pancreatitis. We recommend that a periodic plasma lipid analysi s is needed for patients treated with tamoxifen, especially for diabet ic and hypertriglyceridemic patients, to avoid such complications.