PMC9899696_01
A. Chylomicron was detected in the upper layer when triglyceride was over 3,000 mg/dL.. B. Chylomicron was not detectable after PSL treatment.
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X3
 Upon referral to our clinic, TG level was 2,251 mg/dL, ApoC-II was 19.8 mg/dL, chylomicron was detected at the top of the serum after ultracentrifugation  ( Fig.1A ) . He was administered PSL 15 mg/day, and the chylomicron disappeared after PSL treatment  ( Fig.1B ) .
After discontinuation of PSL, marked hypertriglyceridemia was observed. Although pemafibrate was administrated, it was not effective. After PSL was re-administered, triglyceride levels were decreased and platelets counts were increased. When PSL was reduced to 7 mg/day, hyperchylomicronemia recurred again. Then, PSL was increased to 10 mg/day, and TG levels have been controlled. LPL mass, GPIHBP1 mass, anti-LPL antibody and anti-GPIHBP1 antibody were measured at this point (*) and LPL mass, GPIHBP1 mass and anti-GPIHBP1 antibody were measured at this point (**) (Table 1).
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X5
Serum TG levels were significantly improved to around 200 mg/dL, and platelet counts were approximately 10x104 /microL  ( Fig.2 ) .