title: [Coronary heart disease in childhood in familial hypercholesteremia. Maximum therapy with LDL apheresis].
abstract: In children with familial hypercholesterolemia, coronary heart disease requires both medical theraphy and LDL apheresis. We report a case of  verified  occlusion of the anterior descending branch of the left coronary artery in  a 10-year-old patient.  The pathological findings revealed by ergometry established the diagnosis. The goal was to achieve the greatest possible reduction of  lipid parameters and fibrinogen by lowering plasma viscosity employing LDL apheresis. It is  astonishing that this treatment is also well tolerated by children. The basic vascular approaches suffice and shunt operations are not absolutely necessary. The efficacy of this method became vividly apparent by the changes in the skin lesions. Additional angiographic follow-up  and further clinical course wil provide information on the usefulness of this treatment strategy with maximum lipid theraphy and the expected improvement in prognosis.
authors.affiliation: Kardiologische Klinik, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universität Bochum, Bad Oeynhausen. kpmellwig@hdz-nrw.de
authors.forename: K P
authors.initials: KP
authors.lastname: Mellwig
authors.forename: H K
authors.initials: HK
authors.lastname: Schmidt
authors.forename: A
authors.initials: A
authors.lastname: Brettschneider-Meyer
authors.forename: H
authors.initials: H
authors.lastname: Meyer
authors.forename: B R
authors.initials: BR
authors.lastname: Jaeger
authors.forename: A K
authors.initials: AK
authors.lastname: Walli
authors.forename: D
authors.initials: D
authors.lastname: Seidel
authors.forename: D
authors.initials: D
authors.lastname: Horstkotte
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001781:Blood Component Removal / Q000379:methods*; D002648:Child; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000235:genetics / Q000628:therapy*; D005340:Fibrinogen / Q000378:metabolism; D005500:Follow-Up Studies; D006580:Genetic Carrier Screening; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000235:genetics / Q000628:therapy*; D008297:Male; D011973:Receptors, LDL / Q000235:genetics; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D011973:Receptors, LDL; D014280:Triglycerides; D005340:Fibrinogen; D002784:Cholesterol