Abstract
To the Editor:— Recurrent episodes of severe abdominal pain occasionally pose difficult diagnostic problems. Among the less common disorders are diseases such as acute intermittent porphyria, chronic lead poisoning, the periodic fevers, Dietl's crisis, and abdominal migraine. Since the description of the clinical syndrome associated with the primary hyperlipidemias,1,2hyperlipoproteinemia has been added to this list. A young man over a four-year period experienced multiple attacks of severe abdominal pain, necessitating repeated hospitalization and a laparotomy. Diagnoses entertained at various times were cholecystitis, chronic relapsing pancreatitis, adhesions, perinephric abscess, partial bowel obstruction, influenza syndrome, and appendicitis. Fat-induced hyperlipoproteinemia (type V) has now been proven. Presumptive and definitive diagnosis can be made with ease once one is acquainted with its distinctive clinical manifestations. Report of a Case:— A 27-year-old man was admitted to the US Naval Station Hospital, Argentia, Newfoundland, on Dec 27, 1967, with severe abdominal pain. The patient