학술논문

Difficult Journey to Find the Best Treatment for Homozygous Familial Hypercholesterolemia: Case Report
Document Type
Academic Journal
Source
International Medical Case Reports Journal. March 31, 2022, Vol. 15, p97, 7 p.
Subject
Hypercholesterolemia -- Genetic aspects -- Drug therapy
Low density lipoproteins -- Genetic aspects -- Health aspects
Genetic screening -- Genetic aspects -- Health aspects
Language
English
ISSN
1179-142X
Abstract
Homozygous familial hypercholesterolemia (HoFH) is a rare autosomal recessive genetic disorder. It is difficult to diagnose and treat it at early stage. We present a nine-year-old boy with HoFH from China. At the beginning, he was misdiagnosed as xanthomatosis in the dermatology department of the local hospital, but the disease did not alleviate after three laser ablation operations. Later, blood lipid monitoring, ultrasound of heart and carotid artery were further added in our hospital, and finally the boy was diagnosed with HoFH by genetic testing. A biallelic mutations was observed in the fourth exon of low density lipoprotein receptor (LDLR): c.418G>A (p.E140K). Our patient achieved a relatively satisfactory therapeutic results after a series of lipidlowering therapies including atorvastatin monotherapy, lipoprotein apheresis and double-filtration plasma pheresis. We found that LDL-C levels obtained 57% reduction from baseline after atorvastatin combined with double-filtration plasma pheresis (DFPP). It was observed that regression of carotid intima-media thickness (cIMT), valve regurgitation and xanthoma occurred after a series of Intensive lipid-lowering therapy. Keywords: homozygous familial hypercholesterolemia, low density lipoprotein cholesterol, double-filtration plasma pheresis
Introduction Homozygous familial hypercholesterolemia (HoFH) is an autosomal genetic disorder characterized by a significant increase in circulating low density lipoprotein cholesterol (LDL-C) and deposition of cholesterol in skin or tendon. [...]