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Acquired hypolipoproteinemia.

Abstract
We present a six-year follow-up of a boy with a novel type of hypolipoproteinemia, with clinical and biochemical features distinct from classical hypoalphalipoproteinemias. There were abnormally low concentrations of total and high-density lipoprotein (HDL) cholesterol, apolipoprotein (apo) B, apo A-I, and apo A-II, and the phospholipids were decreased. The most striking abnormality was an extra fraction containing mainly phospholipids and apo A-I in the HDL3 subfraction. This fraction is reminiscent of concentric 20- to 50-nm-diameter lamellar phospholipid liposomes. Plasma lecithin:cholesterol acyltransferase activity was strongly decreased. We noted a persisting polyclonal hypergammaglobulinemia, hematological abnormalities (hemolytic anemia and thrombocytopenia), and a progressive splenomegaly. After the five-year follow-up, the patient had recurrent severe infections; moderate hematuria and proteinuria developed gradually. Treatment with corticosteroids and immunoglobulins improved thrombocytopenia and hypolipoproteinemia. These clinical and biochemical findings differ from those in the known primary and secondary hypo-alpha-lipoproteinemia syndromes. Although investigation of the relatives suggests a familial predisposition for hypo-alpha-lipoproteinemia, the subject's condition can be regarded as acquired.
AuthorsM De Buyzere, J Delanghe, C Labeur, L Noens, Y Benoit, J Baert, M Rosseneu
JournalClinical chemistry (Clin Chem) Vol. 38 Issue 5 Pg. 776-81 (May 1992) ISSN: 0009-9147 [Print] England
PMID1582035 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Apolipoprotein A-I
  • Apolipoprotein A-II
  • Apolipoproteins B
  • Cholesterol, HDL
  • Lipoproteins
  • Lipoproteins, HDL
  • Lipoproteins, HDL3
  • Phospholipids
  • Phosphatidylcholine-Sterol O-Acyltransferase
Topics
  • Adolescent
  • Anemia, Hemolytic (complications)
  • Apolipoprotein A-I (deficiency)
  • Apolipoprotein A-II (deficiency)
  • Apolipoproteins B (deficiency)
  • Cholesterol, HDL (deficiency)
  • Humans
  • Hypolipoproteinemias (blood, complications, diagnosis)
  • Lipoproteins (blood)
  • Lipoproteins, HDL (blood, ultrastructure)
  • Lipoproteins, HDL3
  • Male
  • Particle Size
  • Phosphatidylcholine-Sterol O-Acyltransferase (blood)
  • Phospholipids (blood)
  • Splenomegaly
  • Thrombocytopenia (complications)

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