Brace yourself, this one’s not for the faint-hearted. A man’s blood became so filled with fats it turned a milky color. His condition was so severe that when he went to the hospital his blood clogged their "blood filtering machine," forcing doctors to perform an archaic and controversial treatment known as bloodletting.
Writing in the journal Annals of Internal Medicine, doctors report the 39-year-old patient showed up to University Hospital Cologne in Germany with a nasty collection of symptoms, including vomiting, malaise, headache, and slowly deteriorating alertness. After spending some time in the hospital, his condition declined and he lost consciousness.
Blood tests quickly revealed the problem: hypertriglyceridemia, albeit an extremely severe case. Hypertriglyceridemia is a condition that results in elevated levels of triglycerides, a type of fat, in the blood. It’s caused by overeating and associated with obesity, however, diabetes and kidney problems can also be a risk factor. In this case, the man had a history of gallstones and was known to be a diabetic.
This man's triglyceride count was over 18,000 mg/dl – that's well over 100 times the healthy level considering that a fit person should have a triglyceride count of less than 150 mg/dL.
The doctors initially tried to treat the man using a process known as plasmapheresis, which removes blood, separates its components, and returns some of them back into the body. However, his blood was so fat-riddled, it clogged the machine.
Stumped, the doctors turned to bloodletting, last popular as a form of cure-all in the late 18th century, which involves simply withdrawing blood from a patient’s body. This technique has been used since ancient times but fell out of favor in mainstream medicine as it can be dangerous and some research has thrown doubt onto its effectiveness. Nevertheless, the doctors had no other options left.
Now in the intensive care unit facing a life-threatening situation, 2 liters of the man's blood was drawn, which the doctors noted appeared cloudy due to the high levels of fat, and replaced it with a donor’s red blood cells and plasma.
Remarkably, it worked. After two days, his triglyceride levels lowered enough to allow the doctors to administer the more conventional plasmapheresis treatment, which finished the job off.
"If plasmapheresis cannot be done due to extreme hyperviscosity, our experience demonstrates that conventional bloodletting with replacement [fluids] may be an effective alternative," the researchers concluded in a case note on the man's treatment.
"To our knowledge, this is the first report to describe this procedure."