- 作者：Kenji Ohba ; Yutaka Oki ; Kiyotaka Fujita ; Fumiko Kameko ; Takanori Moriyama ; Yasuoki Horiike ; Hiroshi Morita ; Akio Matsushita ; Kazumi Iino ; Shigekazu Sasaki ; Hirotoshi Nakamura ; Masato Maekawa
- 关键词：Severe high-density lipoprotein cholesterol deficiency ; Acquired lecithin cholesterol acyltransferase deficiency ; 尾-Quantification method
- 刊名：Clinica Chimica Acta
- 出版年：15 November, 2013
- 年：2013
- 卷：426
- 期：Complete
- 页码：91-94
- 全文大小：405 K
Background
Severe hypo-high-density lipoprotein (HDL) cholesterolemia is defined by serum values less than 20 mg/dl. Few acquired cases, without serious underlying disease, have been reported.Case
An asymptomatic 75-y-old man was admitted for evaluation of low serum HDL-cholesterol (HDL-C) levels (2-8 mg/dl). The record of periodic medical examinations revealed that a sudden decrease had occurred 5 y ago. Mild anemia and proteinuria were noted but the liver and thyroid function tests were normal. 尾-Quantification revealed a relatively low HDL-C (10.8 mg/dl) and the serum lecithin cholesterol acyltransferase (LCAT) activity was low (29.4 nmol/ml/h). Unexpectedly, serum HDL-C levels recovered 2 y after hospital discharge. In addition, the serum LCAT activity, hemoglobin concentrations, and urine protein tests all returned to within the reference interval. Subsequent examinations could not clarify the cause of the sudden onset and spontaneous recovery of the extremely low HDL-C.
Conclusions
We describe an unusual case of acquired HDL-C deficiency in a 75-y-old man that did not have serious pre-existing disease. Recently, extremely low HDL-C levels in patients with the nephrotic syndrome, associated with acquired LCAT deficiency, have been reported. The present case might illustrate a milder form of this disorder, because the clinical findings show many similarities.