Severe Hypercholesterolemia Mediated by Lipoprotein X in an Immunosuppressed Patient: A Case Report
Cholestatic liver diseases may be associated with increased plasmatic cholesterol due to an abnormal lipoprotein – lipoprotein X (LpX). Correcting the underlying cause of cholestasis is the critical treatment of LpX-associated hypercholesterolemia without any proven benefit from conventional lipid-l...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2022-10-01
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| Series: | GE: Portuguese Journal of Gastroenterology |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/526854 |
| _version_ | 1811216805487706112 |
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| author | Cristiana Sequeira Mariana Coelho Inês Costa Santos Sara Ramos Lopes João Mangualde Ana Paula Oliveira |
| author_facet | Cristiana Sequeira Mariana Coelho Inês Costa Santos Sara Ramos Lopes João Mangualde Ana Paula Oliveira |
| author_sort | Cristiana Sequeira |
| collection | DOAJ |
| description | Cholestatic liver diseases may be associated with increased plasmatic cholesterol due to an abnormal lipoprotein – lipoprotein X (LpX). Correcting the underlying cause of cholestasis is the critical treatment of LpX-associated hypercholesterolemia without any proven benefit from conventional lipid-lowering agents. In some situations, plasma exchange may apply to prevent associated complications, such as hyperviscosity syndrome. The authors present the case of a 44-year-old man with orbital inflammatory pseudotumor on prednisolone, admitted due to hepatocellular and cholestatic lesion and severe hypercholesterolemia. Laboratory investigation established that hepatitis E virus was responsible for liver injury and showed that LpX mediated the severe hypercholesterolemia. Reduction of the immunosuppressive load contributed to virus clearance. The consequent resolution of cholestasis and cholesterol removal by plasmapheresis allowed lipid profile normalization. The authors report the first case of LpX-associated hypercholesterolemia in a patient with hepatitis E-induced cholestasis and revisit the role of the liver in lipid metabolism. |
| first_indexed | 2024-04-12T06:44:24Z |
| format | Article |
| id | doaj.art-0b72b6ebc6a04ddd89e78902ca1104b1 |
| institution | Directory Open Access Journal |
| issn | 2341-4545 2387-1954 |
| language | English |
| last_indexed | 2024-04-12T06:44:24Z |
| publishDate | 2022-10-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | GE: Portuguese Journal of Gastroenterology |
| spelling | doaj.art-0b72b6ebc6a04ddd89e78902ca1104b12022-12-22T03:43:36ZengKarger PublishersGE: Portuguese Journal of Gastroenterology2341-45452387-19542022-10-011510.1159/000526854526854Severe Hypercholesterolemia Mediated by Lipoprotein X in an Immunosuppressed Patient: A Case ReportCristiana SequeiraMariana CoelhoInês Costa Santoshttps://orcid.org/0000-0003-3332-8590Sara Ramos LopesJoão MangualdeAna Paula OliveiraCholestatic liver diseases may be associated with increased plasmatic cholesterol due to an abnormal lipoprotein – lipoprotein X (LpX). Correcting the underlying cause of cholestasis is the critical treatment of LpX-associated hypercholesterolemia without any proven benefit from conventional lipid-lowering agents. In some situations, plasma exchange may apply to prevent associated complications, such as hyperviscosity syndrome. The authors present the case of a 44-year-old man with orbital inflammatory pseudotumor on prednisolone, admitted due to hepatocellular and cholestatic lesion and severe hypercholesterolemia. Laboratory investigation established that hepatitis E virus was responsible for liver injury and showed that LpX mediated the severe hypercholesterolemia. Reduction of the immunosuppressive load contributed to virus clearance. The consequent resolution of cholestasis and cholesterol removal by plasmapheresis allowed lipid profile normalization. The authors report the first case of LpX-associated hypercholesterolemia in a patient with hepatitis E-induced cholestasis and revisit the role of the liver in lipid metabolism.https://www.karger.com/Article/FullText/526854lipoprotein xhypercholesterolemiahepatitis e |
| spellingShingle | Cristiana Sequeira Mariana Coelho Inês Costa Santos Sara Ramos Lopes João Mangualde Ana Paula Oliveira Severe Hypercholesterolemia Mediated by Lipoprotein X in an Immunosuppressed Patient: A Case Report GE: Portuguese Journal of Gastroenterology lipoprotein x hypercholesterolemia hepatitis e |
| title | Severe Hypercholesterolemia Mediated by Lipoprotein X in an Immunosuppressed Patient: A Case Report |
| title_full | Severe Hypercholesterolemia Mediated by Lipoprotein X in an Immunosuppressed Patient: A Case Report |
| title_fullStr | Severe Hypercholesterolemia Mediated by Lipoprotein X in an Immunosuppressed Patient: A Case Report |
| title_full_unstemmed | Severe Hypercholesterolemia Mediated by Lipoprotein X in an Immunosuppressed Patient: A Case Report |
| title_short | Severe Hypercholesterolemia Mediated by Lipoprotein X in an Immunosuppressed Patient: A Case Report |
| title_sort | severe hypercholesterolemia mediated by lipoprotein x in an immunosuppressed patient a case report |
| topic | lipoprotein x hypercholesterolemia hepatitis e |
| url | https://www.karger.com/Article/FullText/526854 |
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