Presentation
Peer Review reports Background Most of the patients with type 1 and V hyperlipoproteinemia (HLP) present with symptoms and signs of acute pancreatitis due to marked elevation of triglycerides levels, but this baby presented with a chest infection instead [bmcendocrdisord.biomedcentral.com]
If a creamy supernatant is seen the next day, chylomicrons are present. [wikidoc.org]
Carriers of this genotype exhibit the phenotype of HLP type 3 only when other metabolic, exogenous or genetic factors are present. [orpha.net]
The formula can only be used if the value of triacylglycerols does not exceed 4.5 mmol/l, chylomicrons must not be present. [wikilectures.eu]
Planar xanthoma was present in one son with myocardial infarction. No chylomicronemia was noted. The response to diet and Atromid-S was satisfactory. [ahajournals.org]
Entire Body System
- Coronary Atherosclerosis
Effects of fluvastatin on coronary atherosclerosis in patients with mild to moderate cholesterol elevations (Lipoprotein and Coronary Atherosclerosis Study [LCAS]). Am J Cardiol. 1997;80:278–86. 15. [aafp.org]
Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society. [bjcardio.co.uk]
Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts. [mdpi.com]
Gastrointestinal
- Abdominal Pain
Features include abdominal pain and eruptive xanthoma. Hyperlipidemia is frequently complicated by pancreatitis. HLP5 can be caused by mutations in the APOA5 gene. The disease is inherited in an autosomal dominant or an autosomal recessive manner. [asperbio.com]
Overview An inherited disorder where the body\'s ability to break down lipids (triglycerides and cholesterol) is impaired resulting in increased blood lipid levels of chylomicrons and VLDL\'s Symptoms - Hyperlipoproteinemia type 5 * Recurrent abdominal [checkorphan.org]
Other signs and symptoms of hyperlipoproteinemia include: pancreatitis (type 1) abdominal pain (types 1 and 5) enlarged liver or spleen (type 1) lipid deposits or xanthomas (type 1) family history of heart disease (types 2 and 4) family history of diabetes [healthline.com]
[…] vessels ) Unwell Xantoma papular or eruptive ( cutaneous fat deposition in yellow pink ) at a point that is pressed and extensor surfaces Recurrent attacks of severe abdominal pain resembling pancreatitis usually preceded by the entry of fat into the [healthout.blogspot.com]
Abstract The history of a 27-year-old woman with 10 years of episodic abdominal pain and the development of calcific pancreatitis secondary to hyperlipo-proteinemia is presented. [link.springer.com]
- Recurrent Abdominal Pain
Overview An inherited disorder where the body\'s ability to break down lipids (triglycerides and cholesterol) is impaired resulting in increased blood lipid levels of chylomicrons and VLDL\'s Symptoms - Hyperlipoproteinemia type 5 * Recurrent abdominal [checkorphan.org]
Clinical features include failure to thrive, eruptive xanthomas over extensor surfaces and buttocks, lipemia retinalis, hepatosplenomegaly, recurrent abdominal pain, nausea and vomiting, and risk of acute pancreatitis [ 10, 11 ]. [mdpi.com]
Liver, Gall & Pancreas
- Hepatosplenomegaly
Signs and Symptoms of Hiperlipoproteinemia Hiperlipoproteinemia Type I Spasma abdominal, rigidity, or tenderness that arise and disappear anorexia fever Hepatosplenomegaly with softening in the liver or spleen Lipemia retinalis ( reddish white retinal [healthout.blogspot.com]
The disease is characterized by atherosclerosis, hepatosplenomegaly, polyneuropathy and orange tonsils. *phew* That's all! [medicowesome.com]
If left untreated, pancreatitis can develop into a chronic condition that can damage the pancreas and, in rare cases, be life-threatening.Affected individuals may also have an enlarged liver and spleen (hepatosplenomegaly). [icdlist.com]
Some individuals may have an abnormally enlarged liver or spleen (hepatosplenomegaly). Individuals with hyperlipoproteinemia type III may eventually develop inflammation of the pancreas (pancreatitis). [rarediseases.org]
Hepatosplenomegaly is also related to the degree of TG elevation and results from lipid accumulation within cells of the reticuloendothelial system. Hepatosplenomegaly is rapidly reversible with correction of plasma TG levels [ 1 ]. [mdpi.com]
- Hepatomegaly
Sensitive hepatomegaly may be observed. Patients develop highly progressive atherosclerosis that can lead to premature cardiovascular disease (stroke, coronary and peripheral artery disease. [orpha.net]
She did not have any evidence of glycogen storage disease (no hepatomegaly or hypoglycemic episodes), nephrotic syndrome, hypothyroidism, or diabetes. [academic.oup.com]
Workup in hypertriglyceridemia On examination, findings may be normal, or they may include the following: GI: Tenderness to palpation over mid-epigastric or upper right/left quadrants; hepatomegaly Dermatologic: Eruptive xanthomas on back (see the image [emedicine.medscape.com]
Musculoskeletal
- Migratory Polyarthritis
FH patients, characterized by extremely high levels of low-density lipoprotein cholesterol (LDL-C), above 400mg/dL in heterozygotes and 600 mg/dL in homozygotes, are prone to recurrent migratory polyarthritis typically involving large joints such as knees [dermatologyadvisor.com]
Eyes
- Lipemia Retinalis
Abstract Of two patients with type 5 hyperlipoproteinemia, one exhibited lipemia retinalis with multiple retinal hemorrhages and intraretinal lipid extravasations. [ncbi.nlm.nih.gov]
Journal Article Of two patients with type 5 hyperlipoproteinemia, one exhibited lipemia retinalis with multiple retinal hemorrhages and intraretinal lipid extravasations. [scholars.duke.edu]
Signs and Symptoms of Hiperlipoproteinemia Hiperlipoproteinemia Type I Spasma abdominal, rigidity, or tenderness that arise and disappear anorexia fever Hepatosplenomegaly with softening in the liver or spleen Lipemia retinalis ( reddish white retinal [healthout.blogspot.com]
Atherosclerosis Lipemia retinalis Prognosis The prognosis is uncertain.Patients with HLP V are at an extremely high risk of developing Pancreatitis ( 17%). [wikidoc.org]
Lipemia retinalis is observed as a discoloration of the usually crimson red blood vessels observed in the periphery of the retina on fundoscopic examination. [dermatologyadvisor.com]
Skin
- Xanthoma
Characteristic findings such as xanthomas 4. [asperbio.com]
Elevated cholesterol with elevated triglycerides NEC Fredrickson's hyperlipoproteinemia, type IIb or III Hyperbetalipoproteinemia with prebetalipoproteinemia Hypercholesteremia with endogenous hyperglyceridemia Hyperlipidemia, group C Tubo-eruptive xanthoma [unboundmedicine.com]
Types Types of xanthomas Description Location Associated condition Eruptive xanthoma Yellow papules with an erythematous border May be tender and itchy Buttocks, back, and extensor surfaces of the extremities Hypertriglyceridemia (chylomicron or VLDL) [amboss.com]
Tuberous xanthomas are associated with types II, III, and IV hyperlipoproteinemia. [dermatologyadvisor.com]
Clinical signs that may appear during adulthood are xanthomas of the eyelids (i.e. xanthelasma), transient xanthomas on palms (i.e. planar palmar xanthomas) or tuberous xanthomas over elbows or knees. Sensitive hepatomegaly may be observed. [orpha.net]
Workup
Dysbetalipoproteinemia Workup. Medscape Reference. Available online at http://emedicine.medscape.com/article/118466-workup. Accessed October 2013. (2007) Bennet A, et al. Association of apolipoprotein E genotypes with lipid levels and coronary risk. [labtestsonline.it]
[…] patients with type 1 and V hyperlipoproteinemia (HLP) present with symptoms and signs of acute pancreatitis due to marked elevation of triglycerides, but this baby presented with a chest infection, which was later diagnosed as type V HLP on laboratory workup [bmcendocrdisord.biomedcentral.com]
Appropriate blood, urine, and radiographic workups are required to rule out a secondary cause of hyperlipidemia. Lipoprotein profiles are primarily used to assess cardiac risk and to aid in the diagnosis of lipid metabolism disorders. [namrata.co]
See Workup for more detail. [emedicine.medscape.com]
Serum
- Hypertriglyceridemia
A New Equation for Calculation of Low-Density Lipoprotein Cholesterol in Patients With Normolipidemia and/or Hypertriglyceridemia. [amboss.com]
Management of hypertriglyceridemia Nonpharmacotherapeutic management Nonpharmacologic management of hypertriglyceridemia is generally the initial treatment for patients with this condition. [emedicine.medscape.com]
Conclusions Moderate hypertriglyceridemia is a risk factor for cardiovascular disease; severe hypertriglyceridemia, for pancreatitis. [cmaj.ca]
- Chylomicrons Increased
Type I hyperlipoproteinemia Chylomicrons increased in childhood. VLDL increased later in life. Lab findings: Increase in serum triglycerides. Why? CPL (Capillary lipprotein lipase) hydrolyzes triglycerides in lipoproteins. [medicowesome.com]
Treatment
The treatment includes supplementation of vitamin E. [amboss.com]
Total plasma cholesterol .was reduced by 17% during treatment with 8 g and somewhat more (26%) during treatment with 16 g of cholestyramine daily. [atherosclerosis-journal.com]
Management and treatment Treatment includes a diet poor in carbohydrates and saturated fat, exercise, and lipid-lowering drugs (e.g. fibrates, statins) and is usually sufficient for complete regression of the disease within a few months. [orpha.net]
A Review Article on Hyperlipidemia: Types, Treatments and New Drug Targets. [biomedpharmajournal.org]
Treatment The evaluation and treatment decisions for HLP V should be based on patient-centered and individual circumstances. [wikidoc.org]
Prognosis
Prognosis - Hyperlipoproteinemia type 5 Not supplied. Treatment - Hyperlipoproteinemia type 5 The most effective treatment for type V is weight reduction and long-term maintenance of a low-fat diet. Alcoholic beverages must be avoided. [checkorphan.org]
[…] heart attacks, stroke, etc. than the general population Please find comprehensive information on Familial Dysbetalipoproteinemia regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis [dovemed.com]
Prognosis Without treatment, patients have a 5-10 times higher risk of premature and recurrent atherothrombotic events than the general population. The documents contained in this web site are presented for information purposes only. [orpha.net]
Atherosclerosis Lipemia retinalis Prognosis The prognosis is uncertain.Patients with HLP V are at an extremely high risk of developing Pancreatitis ( 17%). [wikidoc.org]
PMID: 22943927 Prognosis Dildar S, Shamsi TS BMC Endocr Disord 2020 Feb 11;20(1):22. doi: 10.1186/s12902-020-0502-0. [ncbi.nlm.nih.gov]
Etiology
Etiology Acquired (more common) Obesity Diabetes mellitus Physical inactivity Heavy consumption of alcohol Hypothyroidism Nephrotic syndrome Cholestatic liver disease Cushing disease Drugs: antipsychotics, beta blockers (e.g., metoprolol), oral contraceptive [amboss.com]
Their etiology is not precisely century with the first clinical recognition of known, so we have included chapters that dis symptoms and patterns for diagnosis of car cuss many aspects of congenital cardiac mal diovascular diseases. [books.google.com]
Etiology The disease results from mutations in the APOE gene (19q13.31) encoding apolipoprotein E, a protein mediating the cellular uptake of triglyceride-rich lipoprotein remnants (i.e., IDLs with roughly equal amounts of cholesterol and triglycerides [orpha.net]
Etiology Aging (Albany NY) 2019 May 14;11(9):2549-2550. doi: 10.18632/aging.101969. [ncbi.nlm.nih.gov]
Fredrickson applying electrophoresis methods to the separation of lipoproteins developed a classification of lipoprotein disorders.[1] Classification Classification based on etiology Although the exact etiology of HLP V remains unclear till date,it has [wikidoc.org]
Epidemiology
Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Summary Epidemiology Dysbetalipoproteinemia prevalence is estimated at 1/10,000 in the general population. Men are predominantly affected (male-female ratio about 2:1). The disease very rarely occurs before adulthood or in premenopausal women. [orpha.net]
Also, to perform genetic epidemiologic studies of recently identified lipoprotein risk factors for CHD, including Atherogenic Lipoprotein Phenotypes (ALP) based on subclasses of low-density lipoproteins (LDL), Lipoprotein(a) (Lp(a)) and apolipoprotein [clinicaltrials.gov]
Subjects With High Triglycerides Completed NCT00134498 Phase 3 torcetrapib/atorvastatin;atorvastatin 4 Effects of FXR Activation on Hepatic Lipid and Glucose Metabolism Completed NCT00465751 Early Phase 1 chenodeoxycholic acid;placebo capsules 5 Genetic Epidemiology [malacards.org]
Professor of Neurology, Genetics and Epidemiology. Director, Alzheimer's Disease Clinical and Research Program. Boston University Schools of Medicine and Public Health, Boston, MA. Ian R.A. Mackenzie, MD FRCPC. [labtestsonline.it]
Pathophysiology
Classification Pathophysiology Clinical features There are typically no specific signs or symptoms. [amboss.com]
Hypolipoproteinemia Overview Abetalipoproteinemia AR pathophysiology due to mutations in the microsomal triglyceride transfer protein (MTTP) deficiency in apolipoprotein B-48 and B-100 remember: A (without) beta (B) ↓ chylomicrons (B-48), VLDL/LDL (B- [medbullets.com]
Pathophysiology of heart disease : a collaborative project of medical students and faculty. ISBN 978-1496308696. OCLC 1052840871. ^ a b c d e f g h i j k l m n o Chait A, Brunzell JD (June 1990). [en.wikipedia.org]
❑ HETEROZYGOUS: APOA5 gene mutation if present in the heterozygous state, these mutations predispose to hypertriglyceridemia in combination with other genetic factors or pathological conditions.[4][5] Pathophysiology [6] The two main sources of plasma [wikidoc.org]
Prevention
We also look at how to prevent and treat it. Hyperlipidemia means there is too much cholesterol in the blood. Cholesterol is a waxy fat molecule that the liver produces. [medicalnewstoday.com]
[…] risk of heart attacks, stroke, etc. than the general population Please find comprehensive information on Familial Dysbetalipoproteinemia regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention [dovemed.com]
Hyperlipoproteinemia type 5 * Liver cirrhosis * Alcoholic liver cirrhosis * Hemochromatosis * Liver abscess * Liver cysts (see Liver symptoms) * Hydatid cyst of the liver * Polycystic liver disease * Hepatic vein thrombosis * Budd-Chiari syndrome * Fatty liver Prevention [checkorphan.org]
Centers for Disease Control and Prevention. Retrieved 2020-04-30. ^ Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW, García FA, et al. (August 2016). [en.wikipedia.org]
Although it sounds low, FH is readily treatable with lipid-lowering therapy and is a preventable cause of premature cardiac death. [bjcardio.co.uk]