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Severe Hypercholesterolemia Associated with Decreased Hepatic Triglyceride Lipase Activity and Pseudohyponatremia in Patients after Allogeneic Stem Cell Transplantation

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Abstract

A 55-year-old woman with Ph-negative acute lymphoblastic leukemia in primary induction failure received allogeneic peripheral blood stem cell transplantation from her HLA-compatible sister. Pseudohyponatremia developed due to extreme hypercholesterolemia of 4091 mg/dL accompanied by lipoprotein X and lipoprotein Y. The hypercholesterolemia was caused by cholestasis due to chronic GVHD and ischemic cholangiopathy. In addition, we found that hepatic triglyceride lipase (HTGL) activity was severely decreased, which could be another novel factor causing extreme hypercholesterolemia after allogeneic transplantation. The total cholesterol has been gradually decreasing followed by the improvement of cholestasis with bezafibrate, ursodeoxycholic acid and prednisone treatments, and by a slight increase in HTGL-protein. To our knowledge, this is the first report to describe the association of decreased HTGL with extreme hypercholesterolemia after allogeneic transplantation.

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Authors and Affiliations

  1. Departments of Hematology, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, 453-8511, Nagoya, Aichi, Japan

    Yoshihiro Inamoto, Takaomi Sanda, Koichi Miyamura & Yoshihisa Kodera

  2. Departments of Endocrinology, Japanese Red Cross Nagoya First Hospital, Nagoya

    Ikuo Yamamori

  3. Departments of Pathology, Japanese Red Cross Nagoya First Hospital, Nagoya

    Noriyuki Hirabayashi

  4. Department of Internal Medicine, Teikyo University School of Medicine, Tokyo

    Tamio Teramoto

  5. Department of Internal Medicine, Toho University Sakura Hospital, Chiba

    Koji Shirai

  6. Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan

    Hideko Tsukamoto

Authors
  1. Yoshihiro Inamoto
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  2. Tamio Teramoto
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  3. Koji Shirai
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  4. Hideko Tsukamoto
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  5. Takaomi Sanda
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  6. Koichi Miyamura
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  7. Ikuo Yamamori
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  8. Noriyuki Hirabayashi
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  9. Yoshihisa Kodera
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Correspondence to Yoshihiro Inamoto.

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Inamoto, Y., Teramoto, T., Shirai, K. et al. Severe Hypercholesterolemia Associated with Decreased Hepatic Triglyceride Lipase Activity and Pseudohyponatremia in Patients after Allogeneic Stem Cell Transplantation. Int J Hematol 82, 362–366 (2005). https://doi.org/10.1532/IJH97.05064

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  • DOI: https://doi.org/10.1532/IJH97.05064

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