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[Non-dietary, non-pharmacological treatment of severe hypercholesterolemia]
P S Hansen1, J Sølling, T E Knudsen
1Arhus Amtssygehus, medicinsk-kardiologisk afdeling I.
Insights
Low-density lipoprotein (LDL) apheresis effectively reduces cholesterol in severe familial hypercholesterolemia patients. This non-surgical treatment offers a significant decline in serum cholesterol for those with ischemic heart disease.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Severe hypercholesterolemia necessitates non-dietary, non-pharmacological interventions.
- Surgical options include partial ileal bypass, portacaval shunt, and liver transplantation.
Observation:
- Apheresis is a non-surgical method to remove lipoproteins via extracorporeal circulation.
- Methods include plasmapheresis, immunoadsorption, chemical affinity, and Double Membrane Filtration.
Findings:
- LDL-apheresis in a 30-year-old with severe familial hypercholesterolemia and ischemic heart disease yielded a 35% average serum-cholesterol reduction.
- This demonstrates the efficacy of LDL-apheresis in managing severe hypercholesterolemia.
Implications:
- LDL-apheresis is indicated for patients with severe familial hypercholesterolemia and associated ischemic heart disease.
- It is also a crucial treatment option for homozygous familial hypercholesterolemia.
Abstract:
Non-dietary, non-pharmacological reduction of cholesterol in patients with severe hypercholesterolemia can be obtained by partial ileal by-pass, portacaval shunt operation or liver transplantation. A non-surgical method is apheresis, by which low density and very low density lipoproteins are removed from blood in an extracorporal circulation system. Apheresis methods include plasmapheresis, immunoadsorption, chemical affinity and Double Membrane Filtration. Treatment of a 30 year old man with severe familial hypercholesterolemia and ischaemic heart disease, by LDL-apheresis, resulted in an average decline in serum-cholesterol of 35%. LDL-apheresis is indicated in the treatment of this type of patient and in homozygous familial hypercholesterolemia.