Fat overload syndrome in an elderly patient caused by infusion of fat emulsion (C14-24)

Abstract

The patient was an eighty-six years old women suffered from incomplete intestinal obstruction and gastrointestinal bleeding. She was treated with abrosia, hemostatic and antacid agents. At the same time, 20% fat emulsion (C14-24) (250 ml, once daily), 50% glucose (60 ml, once daily), and 5% compound amino acid injection (18 AA-Ⅱ) (250 ml, once daily) were given. On the second day of treatment, the patient showed symptoms of fever, tachycardia, recurrent atrial fibrillation and nausea. After seven days treatment, her laboratory results showed serum triglyceride 10.8 mmol/L, total cholesterol 15.5 mmol/L, aspartate aminotransferase (AST) 248 U/L, alanine aminotransferase (ALT) 100 U/L. After stopping fat emulsion for seven days, her laboratory results were serum triglyceride 8.1 mmol/L, total cholesterol 10.1 mmol/L, AST 62 U/L, ALT 17 U/L, and heart symptoms improved. Fat overload syndrome caused by infusion of fat emulsion was diagnosed. Although the symptoms were improved after the discontinuation of fat emulsion, the patient died of concurrent infection and multiple organ failure. Key words: Fat emulsions, intravenous; Parenteral nutrition; Dyslipidemias