Disturbances in lipid metabolism associated with chylothorax and its management.
Changes in circulating lipid status were studied in a 70-year-old woman during management of chylothorax that included chest drainage, pleuroperitoneal shunting, and a successful thoracic duct ligation. Hypolipidemia with a relative decline in high-density lipoprotein (HDL) cholesterol was apparent at presentation. Following recovery, serum HDL cholesterol rose to the upper limit of normal. Apolipoprotein A-1 (Apo A-1) was discordantly raised during the period of pleuroperitoneal shunting. We speculate that diversion of chylomicrons to the liver with subsequent hydrolysis accounted for a release of Apo A-1 particles into the circulation at a time when the formation of HDL was compromised by a state of starvation.
McKenna
M J
MJ
Division of Endocrinology and Metabolism, Henry Ford Hospital.
Chu
J W
JW
Kahkonen
D M
DM
D000368:Aged; D001053:Apolipoproteins / Q000097:blood; D002784:Cholesterol / Q000097:blood; D002916:Chylothorax / Q000378:metabolism* / Q000628:therapy; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D014280:Triglycerides / Q000097:blood
D001053:Apolipoproteins; D014280:Triglycerides; D002784:Cholesterol