[Pseudohiponatremia secondary to hypertriglyceridemia during the treatment of lymphoblastic lymphoma with corticoids and L-asparaginase].

UNLABELLED: L-asparaginase (L-asp) is an antineoplastic drug used in Leukemia and Lymphoma treatment protocols. Alterations in lipid metabolism have been reported in 10-50% of children treated with L-Asp.

OBJECTIVE

To report an unusual complication of lipid metabolism associated with the use of L-Asp.

CLINICAL CASE: We describe the clinical picture of an adolescent who, during treatment for Lymphoblastic Non-Hodgkin Lymphoma (NHL), presented pseudohyponatremia and hypertriglyceridemia, suspecting an adverse drug reaction (ADR). This suspicion was evaluated according to the modified causality algorithm (Karch and Lasagna), resulting in a "definitive" ADR for the L-asparaginase and corticosteroids association. He received treatment with a low-fat diet and lipid-modifying drugs; L-asparaginase and prednisone were not suspended since the protocol ended. Hypertriglyceridemia recovered without complications after 14 days of treatment.

CONCLUSION

Although the magnitude of the hypertriglyceridemia did not result in clinical pancreatitis, it seems advisable to include ADR suspicion to L-asp among the differential diagnoses, to highlight the need to detect these complications, and to know their prognosis and management in order not to affect the treatment of the patients.