title: A paradoxical severe decrease in serum HDL-cholesterol after treatment with a fibrate.
abstract: There have been a handful of reports in the literature of a paradoxical decrease in serum high density lipoprotein (HDL)-cholesterol in patients on fibrate drugs. The reason for this decline in cardioprotective HDL-cholesterol is not known and may have potential deleterious effects on the patient. This report describes a decrease in serum HDL-cholesterol in a patient on both simvastatin and bezafibrate. This patient also developed abnormal renal function, probably interstitial nephritis. In addition, the literature of fibrate induced serum HDL-cholesterol decline is reviewed and possible mechanisms for this phenomenon discussed.
authors.affiliation: Department of Chemical Pathology, Guy's, St Thomas's, and University Lewisham Hospital, London, UK. martin.crook@gstt.sthames.nhs.uk
authors.forename: M A
authors.initials: MA
authors.lastname: Crook
authors.forename: J
authors.initials: J
authors.lastname: Lynas
authors.forename: R
authors.initials: R
authors.lastname: Wray
mesh_terms: D001629:Bezafibrate / Q000009:adverse effects*; D008076:Cholesterol, HDL / Q000097:blood*; D006801:Humans; D000960:Hypolipidemic Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced
chemical_list: D008076:Cholesterol, HDL; D000960:Hypolipidemic Agents; D001629:Bezafibrate