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Atypical type III hyperlipoproteinemia in a patient with Ig A myelomatosis

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Summary

We studied a 58-year-old woman with severe therapy-refractory hyperlipidemia, xanthomatosis, and multiple myeloma (immunoglobulin A, lambda light chain). The lipid disorder became evident about half a year prior to the expression of myelomatosis. Clinical symptoms were similar to those found in classical type III hyperlipoproteinemia but the underlying metabolic defect was different from the one described in this primary dyslipoproteinemia. The patient has the heterozygous apolipoprotein E3/2 phenotype and her VLDL-cholesterol/serum-triglyceride ratio is unusually low at 0.05. Evidence is given that the hyperlipoproteinemia is due to an impaired catabolism of intermediate density lipoproteins probably because of a reduced hepatic triglyceride lipase activity.

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Abbreviations

AIH:

autoimmune hyperlipidemia

Chol:

cholesterol

HDL:

high density lipoproteins

HLP:

hyperlipoproteinemia

HTGL:

hepatic triglyceride lipase

IDL:

intermediate density lipoproteins

IEF:

isoelectric focusing

Ig:

immunoglobulin

LDL:

low density lipoproteins

LPL:

lipoprotein lipase

PL:

phospholipids

TG:

triglycerides

VLDL:

very low density lipoproteins

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Authors and Affiliations

  1. Abteilung Innere Medizin I, Schwerpunkt Endokrinologie und Stoffwechsel, Medizinische Klinik der Universität Heidelberg, Deutschland

    G. Feussner & R. Ziegler

  2. Abteilung Innere Medizin III, Schwerpunkt Kardiologie, Medizinische Klinik der Universität Heidelberg, Deutschland

    E. von Hodenberg

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  1. G. Feussner
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  2. E. von Hodenberg
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  3. R. Ziegler
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Feussner, G., von Hodenberg, E. & Ziegler, R. Atypical type III hyperlipoproteinemia in a patient with Ig A myelomatosis. Klin Wochenschr 68, 526–532 (1990). https://doi.org/10.1007/BF01648250

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  • DOI: https://doi.org/10.1007/BF01648250

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