TAMOXIFEN-INDUCED HYPERTRIGLYCERIDEMIA - 7 CASE-REPORTS AND SUGGESTIONS FOR REMEDIAL ACTION

We report seven cases of breast adenocarcinoma and hypertriglyceridaem ia associated with the use of tamoxifen. Two cases presented with life -threatening acute pancreatitis. Two cases show a rise in serum trigly cerides (TG) after starling tamoxifen. Five patients had some degree o f insulin resistance or diabetes which may have aggravated the hypertr iglyceridaemia. One additional patient had an apolipoprotein phenotype associated with hypertriglyceridaemia. Fibrates effectively reduced s erum TG levels. In general, tamoxifen improves the lipid profile and t his may account for the reduction in coronary events in patients takin g this drug. However, a rise in serum TG levels has been documented in several studies. Our reports suggest that it is important to screen p atients on tamoxifen since hypertriglyceridaemia could cause potential ly fatal acute pancreatitis or increase the risk of developing ischaem ic heart disease.