title: A sudden onset and the spontaneous remission of severe hypo-high-density lipoprotein cholesterolemia without serious underlying disease: a case report.
abstract: BACKGROUND
  Severe hypo-high-density lipoprotein (HDL) cholesterolemia is defined by serum values less than 20mg/dl. Few acquired cases, without serious underlying disease, have been reported.
  
  
  METHODS
  An asymptomatic 75-y-old man was admitted for evaluation of low serum HDL-cholesterol (HDL-C) levels (2-8 mg/dl). The record of periodic medical examinations revealed that a sudden decrease had occurred 5 y ago. Mild anemia and proteinuria were noted but the liver and thyroid function tests were normal. β-Quantification revealed a relatively low HDL-C (10.8 mg/dl) and the serum lecithin cholesterol acyltransferase (LCAT) activity was low (29.4 nmol/ml/h). Unexpectedly, serum HDL-C levels recovered 2 y after hospital discharge. In addition, the serum LCAT activity, hemoglobin concentrations, and urine protein tests all returned to within the reference interval. Subsequent examinations could not clarify the cause of the sudden onset and spontaneous recovery of the extremely low HDL-C.
  
  
  CONCLUSIONS
  We describe an unusual case of acquired HDL-C deficiency in a 75-y-old man that did not have serious pre-existing disease. Recently, extremely low HDL-C levels in patients with the nephrotic syndrome, associated with acquired LCAT deficiency, have been reported. The present case might illustrate a milder form of this disorder, because the clinical findings show many similarities.
authors.affiliation: Departments of Internal Medicine 2, Hamamatsu University School of Medicine, Hamamatsu, Japan. Electronic address: kenji26dm@gmail.com.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohba
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Oki
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fujita
authors.forename: Fumiko
authors.initials: F
authors.lastname: Kameko
authors.forename: Takanori
authors.initials: T
authors.lastname: Moriyama
authors.forename: Yasuoki
authors.initials: Y
authors.lastname: Horiike
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morita
authors.forename: Akio
authors.initials: A
authors.lastname: Matsushita
authors.forename: Kazumi
authors.initials: K
authors.lastname: Iino
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Sasaki
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Masato
authors.initials: M
authors.lastname: Maekawa
mesh_terms: D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood / Q000172:deficiency; D006801:Humans; D007009:Hypolipoproteinemias / Q000097:blood*; D008297:Male; D012075:Remission, Spontaneous
chemical_list: D008076:Cholesterol, HDL
keywords: Acquired lecithin cholesterol acyltransferase deficiency; Severe high-density lipoprotein cholesterol deficiency; β-Quantification method