Severe type III hyperlipoproteinemia in two patients maintained on chronic hemodialysis

Screening for the apolipoprotein B-100 arginine3500-->glutamine mutation in patients with type III hyperlipoproteinemia

Forty-three patients with clinically and biochemically unequivocally defined type III hyperlipoproteinemia (HLP) were screened for the presence of the apolipoprotein (apo) B-100 arginine3500-->glutamine mutation. This receptor-binding defective apolipoprotein B variant is the cause of familial defective apo B-100 (FDB), an autosomal dominantly inherited disease, which leads to increased plasma cholesterol levels and premature atherosclerosis. Neither patient expressed FDB. It is concluded that the gene defect responsible for FDB is not involved in the pathogenesis of type III HLP.

Expression of type III hyperlipoproteinaemia in a subject with secondary hypothyroidism bearing the apolipoprotein E2/2 phenotype

Post-surgical hypothyroidism developed in a now 43-year-old woman with complete insufficiency of the anterior pituitary gland who discontinued levothyroxine replacement therapy. Serum cholesterol and serum triglyceride levels increased in parallel, and classical type III hyperlipoproteinaemia (HLP) with xanthoma striata palmaris developed. The patient is homozygous for apolipoprotein (apo) E2. The case reported here represents the first example of manifestation of type III hyperlipoproteinaemia in a subject with secondary hypothyroidism bearing the apo E2/2 phenotype.

Type III hyperlipoproteinemia in a child with hemolytic uremic syndrome

The case of a 6-year-old girl with severe hyperlipoproteinemia and chronic renal failure that developed after hemolytic uremic syndrome (HUS) is reported. The patient was homozygous for apolipoprotein (apo) E2, and her very-low-density lipoprotein (VLDL)-cholesterol/serum-triglyceride (TG) ratio of 0.63 was unusually high. She was consistently diagnosed to have type III hyperlipoproteinemia (HLP). This is the first report of type III HLP in a child with chronic renal disease.