Low-density lipoprotein apheresis in a patient aged 3.5 years

Stefanutti, C.; Giacomo, S. Di; Vivenzio, A.; Colloridi, V.; Bosco, Giovanna; Berni, Andrea; Rabbone, Ivana; Cerutti, F; Bertolini, Stefano

doi:10.1080/080352501750258793

Cited by 30 publications

(22 citation statements)

References 15 publications

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“…The youngest child treated by LDL apheresis was 3.5 years old (8), as in our series. The most frequently used method was adsorption by DSC (4,5,8–11), but other procedures were also used: heparin‐induced lipoprotein precipitation (HELP) (7), immunoadsorption (12), direct adsorption by DALI (13), and even non‐specific methods such as plasma exchange (6). Although weekly sessions are more efficient (10), fortnightly sessions were often performed.…”

Section: Discussionsupporting

confidence: 66%

“…Although weekly sessions are more efficient (10), fortnightly sessions were often performed. Vascular access was generally via a PV (5,8,11), but when the blood flow was insufficient an AVF (7) or, in a few cases, a central venous line (6) was used.…”

Section: Discussionmentioning

confidence: 99%

“…Hypochromic anemia has been observed in some studies (4,10), but was not found in our children. The problems of hypovolemia and hypotension were present in the youngest children and could be easily treated by plasma expenders (8). The group using central venous lines for vascular access reported septicemia and thrombosis (6).…”

Section: Discussionmentioning

confidence: 99%

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Low‐density Lipoprotein Apheresis in Children With Familial Hypercholesterolemia: Follow‐up to 21 Years

Palcoux¹,

Atassi-Dumont

Lefevre³

et al. 2008

Ther Apher Dial

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Twenty-seven patients (14 girls, 13 boys) affected by familial hypercholesterolemia who had begun low-density lipoprotein (LDL) apheresis treatment before the age of 15 were studied. The median age at diagnosis was 4 years and the blood LDL cholesterol level was 704 +/- 163 mg/dL. Screening was performed for homozygous or double heterozygous mutations of the LDL cholesterol receptor gene and mutations were found in 24 of the patients. The mean age at the beginning of treatment was 8.5 years and the mean length of follow up was 12.6 years. The two main procedures used were direct adsorption of lipoproteins and dextran sulfate cellulose adsorption. Nine patients experienced anaphylactic reactions due to bradykinin and six had to have their treatment changed. The LDL cholesterol level before the session was lowered by 45 +/- 11% of the value at diagnosis. The LDL cholesterol reduction in a session was 72 +/- 10%. Tendinous xanthomas disappeared or diminished dramatically in 62% of the children. In 22 patients no cardiovascular event occurred during LDL apheresis treatment. Three had angina pectoris; two others had surgical management of aortic stenosis, but no clinical manifestations. Seven children had normal cardiovascular pictures while on treatment. Eleven had abnormalities of the aortic root or coronary arteries, which in six cases had appeared before treatment; the other five children did not undergo prior cardiac evaluation. In five children the abnormalities appeared during treatment. Based on these data, LDL-apheresis can be recommended for the treatment of homozygous familial hypercholesterolemia, even in young children, with good efficiency on biological parameters, cutaneous lesions and cardiovascular events.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

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Low‐density Lipoprotein Apheresis in Children With Familial Hypercholesterolemia: Follow‐up to 21 Years

Palcoux¹,

Atassi-Dumont

Lefevre³

et al. 2008

Ther Apher Dial

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“…With dextran sulfate LDL adsorption, a safe but aggressive, reliable cholesterol‐lowering thereby is possible. More than 60% of the precholesterol values and between 50 and 60% of the pre Lp(a) values can be eliminated by one treatment with the Liposorber system (36,55). The observed side‐effects were between 0.5% and 4%(52–54).…”

Section: Methodsmentioning

confidence: 99%

Is Lipoprotein (a)—Apheresis Useful?

Bambauer¹

2005

Ther Apher Dial

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Numerous epidemiological investigations have shown the importance of cholesterol, and in particular low density lipoprotein (LDL), and of the lipoproteins in the development of coronary sclerosis. A continuing relationship between cholesterol levels and coronary morbidity has been established. The LDL concentration in the blood is, in particular, to be made responsible for the development of arteriosclerosis and especially of coronary heart disease (CHD). Lipoprotein (a) [Lp(a)], as a risk factor for premature cardiovascular and cerebrovascular diseases, can be lowered by LDL-apheresis. Especially in isolated high levels of Lp(a) with CHD or polygenic hypercholesterolemia with elevated Lp(a) levels, LDL-apheresis can be indicated and can be useful to improve endothelium regulation and induce changes in coronary tone by an increase in endothelial derived relaxing factor. Lipoprotein (a) can be dramatically lowered by LDL-apheresis, but clinical improvement especially by low LDL is not still not clarified. Studies with weekly apheresis with statins versus drug therapy alone are necessary. To clarify the controversial discussions of whether lowering Lp(a) may be unnecessary or necessary to arrest progression of CHD, more clinical and randomized studies are needed. Lipoprotein (a) can be also lowered by current LDL-apheresis methods.

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“…При этом возможна регрессия ксантом, регресс атеросклеротического поражения сосудов и замедление прогрессирования атероскле-роза [6,26,[32][33][34]. Обычно процедура проводится 1 раз в 2 нед у детей старше 5 лет [6,26,32], хотя хо-рошие результаты были получены даже у детей бо-лее раннего возраста с массой тела более 13,5 кг [33]. К сожалению, в настоящее время эта процедура име-ет ограниченное применение в педиатрической прак-тике в России.…”

Section: лечениеunclassified

Modern Approaches to the Treatment of Homozygous Familial Hypercholesterolemia

Леонтьева¹

2017

Ross. vestn. perinatol. pediatr.

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Low-density lipoprotein apheresis in a patient aged 3.5 years

Cited by 30 publications

References 15 publications

Low‐density Lipoprotein Apheresis in Children With Familial Hypercholesterolemia: Follow‐up to 21 Years

Low‐density Lipoprotein Apheresis in Children With Familial Hypercholesterolemia: Follow‐up to 21 Years

Is Lipoprotein (a)—Apheresis Useful?

Modern Approaches to the Treatment of Homozygous Familial Hypercholesterolemia

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