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  • 1
    ISSN: 1432-1440
    Keywords: LDL apheresis ; Vitamin E ; Vitamin A ; α-Tocopherol ; Retinol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Serum α-tocopherol and retinol concentrations were followed in four heterozygous adults and one homozygous child with familial hypercholesterolemia being treated by regular low-density lipoprotein (LDL) apheresis. Approximately 50% of plasma α-tocopherol was eliminated during a single apheresis procedure in the heterozygous adults, while a complete elimination of this vitamin along with LDLs was observed in the homozygous child. Absolute losses of α-tocopherol amounted to 13.4–22.5 mg/apheresis and are equivalent to the recommended dietary intake for 1.5 to 2 days. Despite these losses, no changes were observed either in serum α-tocopherol levels or in the ratio of α-tocopherol/total serum lipids after 12 months regular apheresis treatment. Serum retinol concentrations only showed a small decrease on apheresis, there being apparently no specific elimination of this vitamin. The absolute losses ranged from 42–422 µg/apheresis and were, therefore, much lower than the recommended dietary intake of the equivalent of 1500 µg retinol/day. It is concluded that no extra supplementation of these vitamins is required during LDL-apheresis therapy, although it may be advisable to monitor vitamin E status in patients on long-term, intensive therapy.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1076
    Keywords: Homozygous familial hypercholesterolaemia ; low-density lipoprotein plasmaphaeresis ; Heparin extracorporeal low-density lipoprotein precipitation ; Lovastatin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 7-year-old girl with homozygous familial hypercholesterolaemia and plasma low-density lipoprotein (LDL)-cholesterol levels of 820 mg/dl (21.2 mmol/l) and progressive xanthomata was treated with heparin extracorporeal low-density lipoprotein precipitation (HELP) to lower her plasma LDL. On weekly HELP treatment she maintained her pre-HELP treatment LDL-cholesterol levels at 409 mg/dl (10.6 mmol/l). The long-term HELP treatment was well tolerated and led to regression of her xanthomata. Subsequently, lovastatin [Mevacor; Merck Sharp & Dohme, Westpoint, Pa., USA (20 mg/day)] was added to the regimen, causing a further 20% decrease in her pre-HELP treatment plasma LDL-cholesterol levels. Lovastatin alone did not sufficiently lower her plasma LDL and could not replace the weekly HELP therapy. Our data show that lovastatin is an effective adjunctive therapy for lowering plasma LDL-cholesterol in a homozygous patient, once plasma LDL levels have already been lowered by regular HELP treatment.
    Type of Medium: Electronic Resource
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