Changes in plasma lipids and abnormal lipoproteins in a patient with drug-induced cholestatic hepatitis

Changes in plasma lipids and abnormal lipoproteins in a patient with ticlopidine hydrochloride-induced hepatitis were studied. Total cholesterol, free cholesterol and phospholipids increased markedly during cholestasis. Lipoprotein electrophoresis showed a large lipoprotein-X band and a relatively small alpha-lipoprotein band. As cholestatic hepatitis improved, all plasma lipids were progressively decreased. A broad band of abnormal alpha-lipoprotein appeared for the first time with the decrease in the lipoprotein-X band. Both abnormal lipoproteins decreased further and eventually disappeared. The appearance of abnormal alpha-lipoprotein was accompanied by changes in apoproteins. These findings suggest that abnormal alpha-lipoprotein might be an intermediate metabolite of lipoprotein-X.