[Hyperalphalipoproteinemia: causes of therapeutic errors in primary care].
OBJECTIVE
To consider using request for cholesterol together with high density lipoproteins (cHDL) before any hypolipemic treatment.


METHODS
Three clinical observations.


METHODS
General medicine surgery of the La Orden Health Centre in Huelva.


METHODS
Patients diagnosed with hyperalphalipoproteinemia in whom the total cholesterol (Ct) rate did not lower after treatment with hypolipemic drugs and diet.


RESULTS
In all patients, the Ct, triglyceride (TG), cHDL, cholesterol together with low density lipoproteins (cLDL), very low density lipoproteins (cVLDL) and apoprotein A1 (Apo A1) were determined using enzymatic, ultracentrifuge and immunonephelometric methods. The cHDL reference value was 30-70 and 30-85 mg/dl in males and females respectively. The results obtained in the three observations were: Ct (288, 292 and 284 mg/dl) cHDL (118, 122 and 114 mg/dl) Apo A1 (2.44, 2.36 and 2.02 milligrams) which were all high, whereas cLDL and cVLDL and the TG obtained normal results.


CONCLUSIONS
We consider it necessary to carry out a cHDL and cLDL study before starting any type of hypolipemic treatment. The clinical importance of correct diagnosis of hyperalphalipoproteinemia is obvious, as hypercholesterolemia can be treated with hypolipemic drugs in spite of cLDL being normal. The cases described underline the importance of basing decisions on the treatment of hypercholesterolemia in cLDL figures and not in Ct figures.
Márquez Contreras
E
E
Centro de Salud La Orden, Huelva.
Rodríguez Peña
F
F
D000328:Adult; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy; D006951:Hyperlipoproteinemias / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008074:Lipoproteins / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D014280:Triglycerides / Q000097:blood
D000960:Hypolipidemic Agents; D008074:Lipoproteins; D008075:Lipoproteins, HDL; D014280:Triglycerides; D002784:Cholesterol
Hiperalfalipoproteinemias: causas de errores terapéuticos en atención primaria.