Regression of Achilles tendon xanthomas evaluated by CT scan after hypolipidemic treatment with simvastatin. A case report.
Familial hypercholesterolemia (FH) is a relatively common autosomal monogenic disease with dominant inheritance and threefold to fourfold increase in relative risk of cardiovascular death in untreated patients. For a "definitive" clinical diagnosis of FH the Simon Broome Register proposes the presence of tendon xanthomas as a key feature. However, detection of tendon xanthomas by physical examination is subjective and difficult to use for follow-up purposes. Several instrumental methods have been reported to be more sensitive than physical examination for the evaluation of xanthomas. The present case illustrates the usefulness of computed tomography (CT) to detect xanthomas in the Achilles tendons (XAT) and their regression in response to hypolipidemic drug treatment in a heterozygous FH patient. As XAT are atherosclerotic plaque-like depositions of lipids it is likely that their progression or regression follows the behavior of vascular atherosclerotic lesions.
Kolovou
Genovefa
G
1st Cardiology Department of the Onassis Cardiac Surgery Center, Athens, Greece. g_kolovou@yahoo.co.uk
Daskalova
Deliana
D
Mastorakou
Irene
I
Anagnostopoulou
Katherine
K
Cokkinos
Dennis V
DV
D000125:Achilles Tendon / Q000000981:diagnostic imaging*; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006938:Hyperlipoproteinemia Type II / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications / Q000000981:diagnostic imaging; D019821:Simvastatin / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D014973:Xanthomatosis / Q000150:complications* / Q000000981:diagnostic imaging
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin