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NEJM：掌纹黄瘤-病例报道

2018-05-10 xing.T MedSci原创

掌纹黄瘤高胆固醇血症LDL
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帕尔马黄色瘤也可见于III型高脂蛋白血症（家族性坏蛋白血症）患者。黄色瘤很少如此严重，以至于妨碍日常生活。在开始每周进行低密度脂蛋白分离术后3个月内，病变几乎消失，患者报告疼痛缓解和功能大幅改善。

患者为一名49岁的男性，转诊至代谢诊所以评估严重的高胆固醇血症和黄色瘤，手部特别明显。病变部位疼痛，并影响了患者的日常生活，使他很难打开瓶子或握手。由于缺血性胆管病，他有2年的胆汁性肝硬化病史。



实验室检查显示总胆固醇水平为970毫克/分升（25.1毫摩尔/升）;甘油三酯水平为158毫克/分升（1.8毫摩尔/升）;低密度脂蛋白（LDL）胆固醇水平为875毫克/分升（22.6毫摩尔/升），存在脂蛋白-X;以及高密度脂蛋白胆固醇水平为64毫克/分升（1.7毫摩尔/升）。

该患者开始采用LDL分离技术治疗。帕尔马黄色瘤也可见于III型高脂蛋白血症（家族性坏蛋白血症）患者。黄色瘤很少如此严重，以至于妨碍日常生活。在开始每周进行低密度脂蛋白分离术后3个月内，病变几乎消失，患者报告疼痛缓解和功能大幅改善。

在就诊后的10年随访中，患者处于稳定状态，并且每隔一周进行一次LDL分离治疗。自LDL血液分离术开始以来，该患者的LDL胆固醇水平降低到110毫克/分升（2.8毫摩尔/升）。

原始出处：

Viktoria F. Koehler,et al.Xanthoma Striatum Palmare. N Engl J Med 2018;https://www.nejm.org/doi/full/10.1056/NEJMicm1713658

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    2018-08-06 1e145228m78(暂无匿称)

    学习了，谢谢作者分享!

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=336888, encodeId=74c93368885a, content=学习了，谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Mon Aug 06 22:01:41 CST 2018, time=2018-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314635, encodeId=6e9d31463543, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Sun May 13 07:05:56 CST 2018, time=2018-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314262, encodeId=8efb314262a9, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0ad01994393, createdName=溜溜梅不酸, createdTime=Sat May 12 00:11:44 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=313775, encodeId=052b313e75c7, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu May 10 08:59:01 CST 2018, time=2018-05-10, status=1, ipAttribution=)]
    2018-05-13 yfjms

    学习

    0

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    2018-05-12 溜溜梅不酸

    学习了.谢谢分享

    0

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    2018-05-10 龙胆草

    学习谢谢分享

    0

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