The challenges of FCS
The challenges of FCS
FCS is a rare autosomal recessive disease with an estimated incidence of 1-2 in 1 000 000 individuals1
The challenge of diagnosing FCS
Around 67% of patients have described being misdiagnosed2
Clinical characteristics to look out for3
- Lipemic blood, caused by the presence of greatly elevated plasma chylomicrons, even in the fasting state
- Severe hypertriglyceridaemia refractory to standard lipid-lowering therapies
- No secondary causes of high TGs (alcohol, uncontrolled diabetes)
- History of acute pancreatitis/abdominal pain of unknown cause
Patients with FCS have plasma triglyceride levels 10–100 times the normal value*5
The most severe clinical consequence of chylomicronaemia is increased risk of recurrent and potentially fatal acute pancreatitis5
* 17–170 mmol/L
The challenge of living with FCS2
Patients with FCS frequently experience manifestations that have a considerable impact on their daily lives.2 75% of patients felt that their social lives were restricted by FCS.2
Despite a restrictive diet, the risk of adverse consequences of raised TGs remains2,6
The FCS diet differs from general low-fat dieting
- <10–15% daily caloric intake from fat or 15–20 g of fat per day6,7,8
- Limited simple and refined carbohydrates; limited foods with added sugars6,7
- No alcohol6,7
References
- Stroes E et al. Atheroscler Suppl 2017;23:1–7;
- Davidson M et al. J Clin Lipidol 2018;12(4):898–907.
- Brahm AJ, Hegele RA. Nat Rev Endocrinol 2015;11:352-62.
- Moulin P, et al. Atherosclerosis. 2018;275:265–272
- Gaudet D et al. N Engl J Med 2014;371:2200–6.
- Alexander L et al. Familial chylomicronaemia Syndrome (FCS): Medical Nutrition Therapy for Patients and Providers. Presented at NLA Scientific Sessions; Philadelphia, PA; 17–20 May, 2017;
- Williams L et al. J Clin Lipidol 2018;12:908–19;
- Burnett JR et al. In: Adam MP, Ardinger HH, Pagon RA et al. Editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993–2017. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1308/ (Accessed February 2021))
The risk for acute pancreatitis1
Patients with FCS have an increased risk of pancreatitis compared with patients with severe hyper-triglyceridaemia caused by other conditions1,5*
*All comparisons were made versus a sample of 364 normolipidaemic individuals using logistics regression models controlling for the effect of age, gender and alcohol consumption5
Most common cognitive symptoms2
- Difficulty in concentrating (16%)
- Impaired judgment (11%)
- Brain fog (8%)
- Forgetfulness (8%)
Frequency2
Patients experienced these symptoms daily or every other day.
Most common physical symptoms2
- Generalized abdominal pain (41%)
- Bloating (37%)
- Feeling of physical weakness (30%)
- Indigestion (27%)
- Fatigue (23%)
Frequency2
Patients reported experiencing these symptoms twice a week to once every 2 weeks.
Most common emotional symptoms2
- Constant uncertainty about the possibility of an attack of acute pancreatitis or pain at any time (34%)
- Anxiety/fear/worry about health because of FCS (26%)
- Uncertainty about what or how much to eat (20%)
- Feeling out of contol/helpless because of FCS (17%)
Frequency2
Patients experienced these symptoms several times a week to once monthly.