A case of marked hyperlipoprotein(a)emia associated with nephrotic syndrome and advanced atherosclerosis.
In 1989, we encountered a 68-year-old male patient with marked hyperlipoprotein(a)emia (hyperLp(a)emia), who was being treated for hypertension and arteriosclerotic obliterans (ASO) at an outpatient clinic of our hospital. He began to develop leg edema in 2002 and was referred to the Department of Internal Medicine. It was determined that he had severe hyperlipidemia (total cholesterol, 362 mg/dl), proteinuria, and hypoalbuminemia, suggesting the presence of nephrotic syndrome. On lipoprotein analysis, he was found to have very high levels of Lp(a) in the plasma (329 mg/dl). Severe atherosclerosis was also found: that is, abdominal aortic aneurysm (AAA) and coronary artery disease (CAD) were detected, in addition to ASO. After remission of the nephrotic syndrome, the plasma Lp(a) level decreased to 204 mg/dl and the total cholesterol concentration decreased to 179 mg/dl, while very high levels of Lp(a) persisted. We estimate that the markedly elevated Lp(a) plasma levels in this patient may have played some role in the progression of atherosclerosis.
Kuge
Yoko
Y
Department of Internal Medicine, Kawanishi City General Hospital, Hyogo, Japan.
Nozaki
Shuichi
S
Kitagawa
Akinori
A
Inoue
Takuya
T
Otsuka
Hiroyuki
H
Ito
Yoshiharu
Y
D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D006951:Hyperlipoproteinemias / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
D017270:Lipoprotein(a)