title: Treatment of a patient with congenital analbuminemia with atorvastatin and albumin infusion.
abstract: Congenital analbuminemia is a rare autosomic recessive inherited disorder characterized by low plasma albumin and hypercholesterolemia, which may increase cardiovascular risk. Patients are essentially asymptomatic, apart from ease of fatigue, minimal ankle oedema and hypotension. There is no accepted strategy for safely treating both hypercholesterolemia and analbuminemia in order to eventually decrease the atherosclerotic risk. We report a case of congenital analbuminemia (1.0 g/dL) in a 38-year-old male with hypercholesterolemia (range: 406-475 mg/dL) and severe arterial dysfunction [no brachial artery flow-mediated dilation (FMD)]. Long-term, cholesterol-lowering treatment with atorvastatin was associated with the appearance of peripheral edema. Two-months of infusion with albumin improved FMD (7%) and reduced serum cholesterol (273 mg/dL), supporting the hypothesis of a compensatory role of hypercholesterolemia. Statin treatment, together with periodical albumin infusions, may contribute to the safe reduction of cardiovascular risk.
authors.affiliation: Maria Del Ben, Francesco Angelico, Lorenzo Loffredo, Francesco Violi, Clinica Medica I, Sapienza University, 00161 Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Del Ben
authors.forename: Francesco
authors.initials: F
authors.lastname: Angelico
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Loffredo
authors.forename: Francesco
authors.initials: F
authors.lastname: Violi
keywords: Albumin infusion; Analbuminemia; Atorvastatin; Endothelial dysfunction; Hypercholesterolemia