title: Management of familial hypercholesterolemia in children and young adults: consensus paper developed by a panel of lipidologists, cardiologists, paediatricians, nutritionists, gastroenterologists, general practitioners and a patient organization.
abstract: Since heterozygous familial hypercholesterolemia (HeFH) is a disease that exposes the individual from birth onwards to severe hypercholesterolemia with the development of early cardiovascular disease, a clear consensus on the management of this disease in young patients is necessary. In Belgium, a panel of paediatricians, specialists in (adult) lipid management, general practitioners and representatives of the FH patient organization agreed on the following common recommendations. 1. Screening for HeFH should be performed only in children older than 2 years when HeFH has been identified or is suspected (based on a genetic test or clinical criteria) in one parent.2. The diagnostic procedure includes, as a first step, the establishment of a clear diagnosis of HeFH in one of the parents. If this precondition is satisfied, a low-density-lipoprotein cholesterol (LDL-C) levelabove 3.5 mmol/L (135 mg/dL) in the suspected child is predictive for differentiating affected from non-affected children. 3. A low saturated fat and low cholesterol diet should be started after 2 years, under the supervision of a dietician or nutritionist.4. The pharmacological treatment, using statins as first line drugs, should usually be started after 10 years if LDL-C levels remain above 5 mmol/L (190 mg/dL), or above 4 mmol/L (160 mg/dL) in the presence of a causative mutation, a family history of early cardiovascular disease or severe risk factors. The objective is to reduce LDL-C by at least 30% between 10 and 14 years and, thereafter, to reach LDL-C levels of less than 3.4 mmol/L (130 mg/dL).
  
  
  CONCLUSIONS
  The aim of this consensus statement is to achieve more consistent management in the identification and treatment of children with HeFH in Belgium.
authors.affiliation: Département de Médecine Interne et Centre de Recherche Médicale de Jolimont, Hôpital de Jolimont, Haine Saint-Paul, Belgium.
authors.forename: O S
authors.initials: OS
authors.lastname: Descamps
authors.forename: S
authors.initials: S
authors.lastname: Tenoutasse
authors.forename: X
authors.initials: X
authors.lastname: Stephenne
authors.forename: I
authors.initials: I
authors.lastname: Gies
authors.forename: V
authors.initials: V
authors.lastname: Beauloye
authors.forename: M-C
authors.initials: MC
authors.lastname: Lebrethon
authors.forename: C
authors.initials: C
authors.lastname: De Beaufort
authors.forename: K
authors.initials: K
authors.lastname: De Waele
authors.forename: A
authors.initials: A
authors.lastname: Scheen
authors.forename: E
authors.initials: E
authors.lastname: Rietzschel
authors.forename: A
authors.initials: A
authors.lastname: Mangano
authors.forename: J P
authors.initials: JP
authors.lastname: Panier
authors.forename: J
authors.initials: J
authors.lastname: Ducobu
authors.forename: M
authors.initials: M
authors.lastname: Langlois
authors.forename: J-L
authors.initials: JL
authors.lastname: Balligand
authors.forename: P
authors.initials: P
authors.lastname: Legat
authors.forename: V
authors.initials: V
authors.lastname: Blaton
authors.forename: E
authors.initials: E
authors.lastname: Muls
authors.forename: L
authors.initials: L
authors.lastname: Van Gaal
authors.forename: E
authors.initials: E
authors.lastname: Sokal
authors.forename: R
authors.initials: R
authors.lastname: Rooman
authors.forename: Y
authors.initials: Y
authors.lastname: Carpentier
authors.forename: G
authors.initials: G
authors.lastname: De Backer
authors.forename: F R
authors.initials: FR
authors.lastname: Heller
mesh_terms: D000328:Adult; D002309:Cardiology / Q000379:methods; D002648:Child; D003245:Consensus Statements as Topic; D003657:Decision Making; D005260:Female; D005762:Gastroenterology / Q000379:methods; D058006:General Practice / Q000379:methods; D017408:Guidelines as Topic; D006579:Heterozygote; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000178:diet therapy / Q000235:genetics / Q000628:therapy*; D008055:Lipids / Q000737:chemistry; D008297:Male; D052756:Nutritional Sciences; D010372:Pediatrics / Q000379:methods; D055815:Young Adult
chemical_list: D008055:Lipids