, Volume 4, Issue 1, pp 71-73
Date: 17 Jul 2008

Do diabetes and obesity promote hepatic fibrosis in familial heterozygous hypobetalipoproteinemia?

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The course of NAFLD secondary to familial heterozygous hypobetalipoproteinemia (FHBL), a definite etiology of secondary nonalcoholic fatty liver disease (NAFLD) [13] featuring low density lipoprotein cholesterol (LDL-C) and apolipoprotein B (ApoB) plasma levels less than fifth percentile [4], is unknown. We report on a case with FHBL due to compound heterozygosity and apoB non-detectable in serum in which a long-term follow-up and paired liver biopsies were available.

A 58 year-old obese woman with FHBL was observed in June 2007 for abdominal pain and poorly controlled type 2 diabetes (T2D). The T2D began at the age of 40. It was complicated by peripheral neuropathy of the legs, and a chronic vascular encephalopathy that was documented by computed tomography. The patient was initially treated with a combination therapy (i.e., metformin plus glibenclamide plus insulin). Additional medications used were gabapentin for the peripheral neuropathy, thiamazole for multinodular hyperthyroidism ...