Drug-induced dyslipoproteinemia: a report of two cases.
We describe two cases of atypical dyslipoproteinemia due to drug-induction. This secondary form of lipoprotein abnormality is unique because the newly available drug, miconazole, apparently directly delipidated the alpha-lipoproteins in the bloodstream. On closer study we found that the delipidation was caused by the vehicle rather than the fungicide--more specifically, only by the polyethoxylated castor oil in the vehicle. It affects serum lipoproteins both in vitro and in vivo, and the effect is species-specific. In vitro studies indicate that it preferentially delipidates high-density lipoprotein rather than low-density lipoprotein. Because its effects on the serum lipoproteins of rats resemble those on man, and because aortic lesions were produced in rats injected daily (90 mL/L) with this substance, caution is indicated in long-term use of drugs containing this chemical component in the vehicle.
D000328:Adult; D000818:Animals; D002368:Castor Oil / Q000031:analogs & derivatives / Q000494:pharmacology; D004587:Electrophoresis, Agar Gel; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D007122:Immunoelectrophoresis; D008074:Lipoproteins / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008079:Lipoproteins, VLDL / Q000097:blood; D008297:Male; D008659:Metabolic Diseases / Q000139:chemically induced*; D008825:Miconazole / Q000009:adverse effects*; D011092:Polyethylene Glycols / Q000494:pharmacology; D051381:Rats
D007093:Imidazoles; D008074:Lipoproteins; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D008079:Lipoproteins, VLDL; D011092:Polyethylene Glycols; C023040:polyethoxylated castor oil; D008825:Miconazole; D002368:Castor Oil