Case presentation
This report highlights the decision-making involved in managing a patient who had refractory hypertriglyceridemia, followed by a review of genetic lipodystrophies. The patient is a 43-year-old female with a past medical/surgical history significant for diabetes mellitus, hypertriglyceridemia, hypertension, fibromyalgia, GERD, Sjogren’s syndrome, Rheumatoid arthritis,irritable bowel syndrome, and cholecystectomy. Her home medications are listed in Table 1.She presented to the hospital for persistent abdominal, flank and chest pain refractory to pain management with acetaminophen and ibuprofen at home. This pain started after she was setting decoration for the holidays. She denied anyassociated nausea, vomiting, fevers, chills, recent constipation, diarrhea, shortness of breath, cough, palpitations, or dysuria.