[Increased lipoprotein(a) in a paediatric patient associated with nephrotic syndrome].
A common complication in paediatric patients with nephrotic syndrome (NS) is hyperlipidaemia. About 20% of children do not respond to treatment with corticosteroids, presenting with a cortico-resistant NS (CRNS), which can progress to kidney failure. It has been observed that paediatric patients with CRNS have an elevated low density lipoprotein cholesterol (LDL-c), very low density lipoprotein cholesterol (VLDL-c), and triglycerides levels, as well as elevated Lipoprotein-a [Lp (a)] levels. The case is presented of a 5 year old boy, diagnosed with CRNS, presenting with dyslipidaemia with increased LDL-c, Apo-B100, and Lp(a) levels. After the poor prognosis of the renal function, immunosuppressant treatment was started with tacrolimus and atorvastatin to control dyslipidaemia. Although tacrolimus causes an elevation of total cholesterol and LDL-c, the significant alterations of the children lipid profile suggest the existence of a high cardiovascular risk. In these cases, it would be interesting to have reference values in children in our health area.
Laboratorio de Nutrición y RCV, Unidad de Gestión Clínica de Bioquímica Clínica, Hospital Universitario Virgen Macarena, Sevilla, España. Electronic address: palomamenval@hotmail.com.
Paloma
P
Menéndez Valladares
Laboratorio de Nutrición y RCV, Unidad de Gestión Clínica de Bioquímica Clínica, Hospital Universitario Virgen Macarena, Sevilla, España; Facultad de Medicina, Universidad Autónoma de Chile, Providencia, Región Metropolitana, Chile.
Teresa
T
Arrobas Velilla
Endocrinología Pediátrica, Unidad de Gestión Clínica de Pediatría, Hospital Universitario Virgen Macarena, Sevilla, España.
José Antonio
JA
Bermúdez de la Vega
Endocrinología Pediátrica, Unidad de Gestión Clínica de Pediatría, Hospital Universitario Virgen Macarena, Sevilla, España.
María Del Mar
MD
Romero Pérez
Laboratorio de Nutrición y RCV, Unidad de Gestión Clínica de Bioquímica Clínica, Hospital Universitario Virgen Macarena, Sevilla, España.
Fernando
F
Fabiani Romero
Laboratorio de Nutrición y RCV, Unidad de Gestión Clínica de Bioquímica Clínica, Hospital Universitario Virgen Macarena, Sevilla, España.
Concepción
C
González Rodríguez
D053299:Apolipoprotein B-100 / Q000097:blood; D000069059:Atorvastatin / Q000627:therapeutic use; D002675:Child, Preschool; D008078:Cholesterol, LDL / Q000097:blood; D050171:Dyslipidemias / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D011379:Prognosis; D012307:Risk Factors; D016559:Tacrolimus / Q000627:therapeutic use
D053299:Apolipoprotein B-100; D008078:Cholesterol, LDL; D007166:Immunosuppressive Agents; D017270:Lipoprotein(a); D000069059:Atorvastatin; D016559:Tacrolimus
LDL-cholesterol; LDL-colesterol; Lipoprotein(a); Lipoproteína (a); Nephrotic syndrome; Paediatrics; Pediatría; Síndrome nefrótico