title: Successful treatment of homozygous familial hypercholesterolemia using cascade filtration plasmapheresis.
abstract: OBJECTIVE
  The aim of this study was to report the efficacy of low-density lipoprotein cholesterol (LDL-C) apheresisusing a cascade filtration system in pediatric patients with homozygous familial hypercholesterolemia (FH), and toclarify the associated adverse effects and difficulties.
  
  
  METHODS
  LDL-C apheresis using a cascade filtration system was performed in 3 pediatric patientswith homozygous FH; in total, 120 apheresis sessions were performed.
  
  
  RESULTS
  Cascade filtration therapy significantly reduced the mean LDL-C values from 418 ± 62 mg/dL to 145 ± 43 mg/dL (p= 0.011). We observed an acute mean reduction in the plasma level of total cholesterol (57.9%), LDL-C (70.8%),and high-density lipoprotein cholesterol (HDL-C) (40.7%). Treatments were well tolerated. The most frequent clinicaladverse effects were hypotension in 3 sessions (2.5%), chills (1.7%) in 2 sessions, and nausea/vomiting in 3 sessions(2.5%).
  
  
  CONCLUSIONS
  Our experience using the cascade filtration system with 3 patients included good clinical outcomes andlaboratory findings, safe usage, and minor adverse effects and technical problems.
  
  
  BACKGROUND
  None declared.
authors.affiliation: Erciyes University, School of Medicine, Department of Pediatric Metabolism, Kayseri, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Kardaş
authors.affiliation: Erciyes University, School of Medicine, Department of Biochemistry, Kayseri, Turkey.
authors.forename: Aysun
authors.initials: A
authors.lastname: Cetin
authors.affiliation: Erciyes University, School of Medicine, Department of Hematology, Kayseri, Turkey.
authors.forename: Musa
authors.initials: M
authors.lastname: Solmaz
authors.affiliation: Erciyes University, School of Medicine, Department of Hematology, Kayseri, Turkey.
authors.forename: Rüksan
authors.initials: R
authors.lastname: Büyükoğlan
authors.affiliation: Erciyes University, School of Medicine, Department of Hematology, Kayseri, Turkey.
authors.forename: Leylagül
authors.initials: L
authors.lastname: Kaynar
authors.affiliation: Erciyes University, School of Medicine, Department of Pediatric Metabolism, Kayseri, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kendirci
authors.affiliation: Erciyes University, School of Medicine, Department of Hematology, Kayseri, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Eser
authors.affiliation: Erciyes University, School of Medicine, Department of Hematology, Kayseri, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Unal
keywords: Cascade filtration plasmapheresis; Familial hypercholesterolemia; Low-density lipoprotein cholesterol (LDL-C)