title: Successful Direct Adsorption of Lipoproteins (DALI) Apheresis During Pregnancy in an Omani Woman with Homozygous Familial Hypercholesterolemia.
abstract: We report our experience with Direct Adsorption of Lipoproteins (DALI) apheresis in an Omani pregnant woman affected by homozygous familial hypercholesterolemia. To the best of our knowledge this is the first successful pregnancy treated with DALI apheresis. The patient had a history of coronary artery disease, supra-aortic valvular stenosis and severe carotid artery disease with right carotid artery stenting. She was on a regular biweekly DALI apheresis since 2008. In May 2013, she became pregnant and rosuvastatin and ezetimibe were stopped while she continued on DALI apheresis biweekly. This treatment during pregnancy was successful with no major complications. The average low-density lipoprotein cholesterol reduction during therapy was 50%. She spontaneously delivered a healthy male infant (2,400 g) at 37 weeks. We showed that DALI apheresis therapy was safe during pregnancy with a good outcome for both mother and neonate.
authors.affiliation: Department of Obstetrics & Gynecology, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Tamima
authors.initials: T
authors.lastname: Al-Dughaishi
authors.affiliation: Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Waili
authors.affiliation: Department of Biochemistry, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman.
authors.forename: Yajnavalka
authors.initials: Y
authors.lastname: Banerjee
authors.affiliation: Department of Obstetrics & Gynecology, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Shahila
authors.initials: S
authors.lastname: Sheik
authors.affiliation: Department of Surgery, Cardiothoracic Unit, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Hilal
authors.initials: H
authors.lastname: Al-Sabti
authors.affiliation: Department of Pharmacology and Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman; Gulf Health Research, Muscat, Oman.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Al-Zakwani
authors.affiliation: Department of Nursing, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Suad
authors.initials: S
authors.lastname: Al-Mukhaini
authors.affiliation: Department of Surgery, Vascular Unit, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Khalifa
authors.initials: K
authors.lastname: Al Wahaibi
authors.affiliation: Ministry of Health, Muscat, Oman.
authors.forename: Ali T
authors.initials: AT
authors.lastname: Al-Hinai
authors.affiliation: Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Rasadi
keywords: Familial hypercholesterolemia; LDL-apheresis; low density lipoprotein receptor; pregnancy; xanthoma