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Pregnancy in homozygous familial hypercholesterolemia-A case series

Milan Bláha1, Kateřina Veletová2, Vladimír Blaha2

  • 1The 4th Department of Internal Medicine - Haematology, Charles University and University Hospital in Hradec Králové, Hradec Králové, Czech Republic.

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|December 5, 2022
PubMed

Insights

Pregnancy in women with homozygous familial hypercholesterolemia (HoFH) poses significant risks. However, with careful management, including LDL-apheresis, patients without cardiovascular disease may have a favorable prognosis.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Metabolic Disorders

Background:

  • Familial hypercholesterolemia (FH) is an inherited disorder causing lifelong high LDL-C levels and premature atherosclerosis.
  • Pregnancy exacerbates risks for FH patients due to physiological changes and limited treatment options.
  • Extracorporeal LDL-apheresis is a potential therapeutic strategy for managing FH during pregnancy.

Purpose of the Study:

  • To evaluate the risks and outcomes of pregnancy in women with homozygous familial hypercholesterolemia (HoFH).
  • To assess the role of LDL-apheresis in managing HoFH pregnancies.

Main Methods:

  • Case report series of six HoFH women detailing 13 pregnancies.
  • Analysis of pregnancy outcomes including successful births, abortions, and interruptions.
  • Inclusion of cases treated with LDL-apheresis.

Main Results:

  • Pregnancy in HoFH women carries substantial risks, including one lethal complication.
  • Nine pregnancies resulted in successful outcomes.
  • Two successful pregnancies were managed with LDL-apheresis.

Conclusions:

  • HoFH pregnancies present significant risks but can have good outcomes for patients without cardiovascular decompensation.
  • LDL-apheresis is a crucial intervention for managing HoFH during pregnancy.
Abstract

Keywords:
LDL-apheresisatherosclerosiscardiovascular diseasehomozygous familial hypercholesterolemiapregnancy

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