title: Severe hypercholesterolemia mediated by lipoprotein X in a pediatric patient with chronic graft-versus-host disease of the liver.
abstract: We describe a case of extreme hypercholesterolemia, mediated by lipoprotein X, in a 12-year-old Caucasian female who underwent an unrelated allogenic bone marrow transplant for relapsed acute myelocytic leukemia (AML). Her post-transplant course was complicated by severe chronic graft-versus-host disease (GVHD) of the liver. Previously normal serum cholesterol and triglycerides rose to 1,122 mg/dl (29.0 mmol/L) and 1,100 mg/dl (12.4 mmol/L), respectively. Serum cholesterol appeared to be dominantly carried by lipoprotein X. Intra-hepatic cholestasis leading to reflux of bile lipoproteins into the blood stream and subsequent formation of lipoprotein X appears to be the mechanism underlying this phenomenon.
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Hanaa
authors.initials: H
authors.lastname: Zidan
authors.forename: Stanley
authors.initials: S
authors.lastname: Lo
authors.forename: Donald
authors.initials: D
authors.lastname: Wiebe
authors.forename: Julie
authors.initials: J
authors.lastname: Talano
authors.forename: Ramin
authors.initials: R
authors.lastname: Alemzadeh
mesh_terms: D001655:Bile Reflux / Q000209:etiology; D002648:Child; D002780:Cholestasis, Intrahepatic / Q000209:etiology*; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood* / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000209:etiology; D008073:Lipoprotein-X / Q000097:blood*
chemical_list: D008073:Lipoprotein-X