Genetic causes of hypertriglyceridemia (HTG) such as lipoprotein lipase (LPL) deficiency should be considered in severe HTG cases where multiple drug pharmacotherapy and aggressive dietary modifications fail to optimize triglyceride (TG) levels.

• Recognition of a genetic basis of HTG is beneficial in:
• Understanding the reason for failed management
• Reassuring the patient as well as the clinician
• Affected family members can be screened and treated prior to having acute complications.
• Some cases with severe HTG will necessitate using new drugs such as Volanesorsen.