A sudden onset and the spontaneous remission of severe hypo-high-density lipoprotein cholesterolemia without serious underlying disease: a case report.
A sudden onset and the spontaneous remission of severe hypo-high-density lipoprotein cholesterolemia without serious underlying disease: a case report.
复制标题
无严重基础疾病的严重低高密度脂蛋白胆固醇血症突然发病并自发缓解：病例报告。
DOI：
10.1016/j.cca.2013.09.003
复制
发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Maekawa M.
中科院分区：
文献类型：
--
作者：
Ohba K;Oki Y;Fujita K;Kameko F;Moriyama T;Horiike Y;Morita H;Matsushita A;Iino K;Sasaki S;Nakamura H;Maekawa M.
研究背景严重的低高密度脂蛋白胆固醇血症（hypo-high-density lipoprotein cholesterolemia，HDL）定义为血清胆固醇低于20 mg/dl。一名无症状的75岁男性因血清高密度脂蛋白胆固醇（HDL-C）水平低（2-8 mg/dl）而入院。定期体检的记录显示，5年前发生了突然下降。轻度贫血和蛋白尿，但肝功能和甲状腺功能检查正常。β-定量显示HDL-C相对较低（10.8 mg/dl），血清卵磷脂胆固醇酰基转移酶（LCAT）活性较低（29.4 nmol/ml/h）。出乎意料的是，血清HDL-C水平在出院后2年恢复。此外，血清LCAT活性、血红蛋白浓度和尿蛋白检测均恢复至参考区间内。随后的检查无法澄清的突然发病和自发恢复的极低HDL-C的原因。ConclusionsWe描述了一个不寻常的情况下，获得HDL-C缺乏症在一个75岁的男子，没有严重的预先存在的疾病。最近，有报道称肾病综合征患者的HDL-C水平极低，与获得性LCAT缺乏有关。本病例可能说明了这种疾病的一种较轻的形式，因为临床发现显示出许多相似之处。
BackgroundSevere hypo-high-density lipoprotein (HDL) cholesterolemia is defined by serum values less than 20 mg/dl. Few acquired cases, without serious underlying disease, have been reported.CaseAn asymptomatic 75-y-old man was admitted for evaluation of low serum HDL-cholesterol (HDL-C) levels (2–8 mg/dl). The record of periodic medical examinations revealed that a sudden decrease had occurred 5 y ago. Mild anemia and proteinuria were noted but the liver and thyroid function tests were normal. β-Quantification revealed a relatively low HDL-C (10.8 mg/dl) and the serum lecithin cholesterol acyltransferase (LCAT) activity was low (29.4 nmol/ml/h). Unexpectedly, serum HDL-C levels recovered 2 y after hospital discharge. In addition, the serum LCAT activity, hemoglobin concentrations, and urine protein tests all returned to within the reference interval. Subsequent examinations could not clarify the cause of the sudden onset and spontaneous recovery of the extremely low HDL-C.ConclusionsWe describe an unusual case of acquired HDL-C deficiency in a 75-y-old man that did not have serious pre-existing disease. Recently, extremely low HDL-C levels in patients with the nephrotic syndrome, associated with acquired LCAT deficiency, have been reported. The present case might illustrate a milder form of this disorder, because the clinical findings show many similarities.