Severe hypertriglyceridemia caused by tamoxifen-treatment after breast cancer surgery

Endocr J. 1997 Oct;44(5):745-9. doi: 10.1507/endocrj.44.745.

Abstract

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 cases of severe hypertriglyceridemia and/or hyperglycemia induced by tamoxifen. For normalization of their hypertriglyceridemia we need to stop giving tamoxifen. In one of three cases we analyzed her lipoprotein profile in detail with lipoprotein lipase activities and apolipoprotein E phenotype. The case was a 49 year-old woman. After 15 months of tamoxifen administration, she was diagnosed as severe hypertriglyceridemia. Consecutively, severe hyperglycemia was occurred to need insulin therapy. After tamoxifen withdrawal, her triglyceride and glucose levels improved. Her lipolytic enzyme was reduced during tamoxifen treatment. Apolipoprotein E phenotype was uncommon E4/2. Although hypertriglyceridemia was not considered to be a risk factor for coronary heart disease, a marked hypertriglyceridemia might occasionally produce severe lethal pancreatitis. We recommend that a periodic plasma lipid analysis is needed for patients treated with tamoxifen, especially for diabetic and hypertriglyceridemic patients, to avoid such complications.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Antineoplastic Agents, Hormonal / adverse effects*
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Blood Glucose / analysis
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / surgery
  • Carcinoma, Ductal, Breast / drug therapy*
  • Carcinoma, Ductal, Breast / surgery
  • Chemotherapy, Adjuvant
  • Cholesterol / blood
  • Cholesterol / metabolism
  • Estrogen Antagonists / adverse effects*
  • Estrogen Antagonists / therapeutic use
  • Female
  • Humans
  • Hypertriglyceridemia / blood
  • Hypertriglyceridemia / chemically induced*
  • Lipase / drug effects
  • Lipase / metabolism
  • Lipoprotein Lipase / drug effects
  • Lipoprotein Lipase / metabolism
  • Liver / drug effects
  • Liver / enzymology
  • Liver / metabolism
  • Middle Aged
  • Tamoxifen / adverse effects*
  • Tamoxifen / therapeutic use
  • Triglycerides / blood
  • Triglycerides / metabolism

Substances

  • Antineoplastic Agents, Hormonal
  • Blood Glucose
  • Estrogen Antagonists
  • Triglycerides
  • Tamoxifen
  • Cholesterol
  • Lipase
  • Lipoprotein Lipase