Pregnancy in a Woman with Homozygous Familial Hypercholesterolemia Not on Low-Density Lipoprotein Apheresis

Akl C. Fahed; Anwar H. Nassar

doi:10.1055/s-0032-1305798

American Journal of Perinatology Reports, Inhaltsverzeichnis

AJP Rep 2012; 02(01): 033-036
DOI: 10.1055/s-0032-1305798

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pregnancy in a Woman with Homozygous Familial Hypercholesterolemia Not on Low-Density Lipoprotein Apheresis

Akl C. Fahed

¹Department of Genetics, Harvard Medical School, Boston, Massachusetts

,

Anwar H. Nassar

²Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon

› Institutsangaben

Abstract

Pregnancy in women with homozygous familial hypercholesterolemia (FH) has been rarely reported and might pose risks on the mother and her fetus. Although most reported cases remained on low-density lipoprotein (LDL) apheresis, there are no clear guidelines regarding the management of this entity. We report the first case of an uncomplicated pregnancy in a 24-year-old homozygous FH woman who was not maintained on LDL apheresis. FH expresses a wide variability in the phenotype, and management of homozygous FH cases who desire to become pregnant should be individualized based on preconceptional assessment with frequent antenatal follow-up. Decisions on management should be made after weighing the risks versus benefits of LDL apheresis.

Keywords

homozygous familial hypercholesterolemia - pregnancy - LDL apheresis - outcome

Volltext

Referenzen

References
1 Fahed AC, Safa RM, Haddad FF , et al. Homozygous familial hypercholesterolemia in Lebanon: a genotype/phenotype correlation. Mol Genet Metab 2011; 102: 181-188
2 De Assis SM, Seguro AC, Helou CM. Effects of maternal hypercholesterolemia on pregnancy and development of offspring. Pediatr Nephrol 2003; 18: 328-334
3 Thadhani R, Stampfer MJ, Hunter DJ, Manson JE, Solomon CG, Curhan GC. High body mass index and hypercholesterolemia: risk of hypertensive disorders of pregnancy. Obstet Gynecol 1999; 94: 543-550
4 Anedda S, Mura S, Marcello C, Pintus P. HELP LDL-apheresis in two cases of familial hypercholesterolemic pregnant women. Transfus Apheresis Sci 2011; 44: 21-24
5 Ertorer ME, Guvenc B, Haydardedeoglu B, Tekinturhan F. A case report of the cascade filtration system: a safe and effective method for low-density lipoprotein apheresis during pregnancy. Ther Apher Dial 2008; 12: 396-400
6 Cashin-Hemphill L, Noone M, Abbott JF, Waksmonski CA, Lees RS. Low-density lipoprotein apheresis therapy during pregnancy. Am J Cardiol 2000; 86: 1160 , A10
7 Klingel R, Göhlen B, Schwarting A, Himmelsbach F, Straube R. Differential indication of lipoprotein apheresis during pregnancy. Ther Apher Dial 2003; 7: 359-364
8 Beigel Y, Bar J, Cohen M, Hod M. Pregnancy outcome in familial homozygous hypercholesterolemic females treated with long-term plasma exchange. Acta Obstet Gynecol Scand 1998; 77: 603-608
9 Fahed AC, Nemer GM. Familial hypercholesterolemia: the lipids or the genes?. Nutr Metab (Lond) 2011; 8: 23
10 Hameed AB, Tummala PP, Goodwin TM , et al. Unstable angina during pregnancy in two patients with premature coronary atherosclerosis and aortic stenosis in association with familial hypercholesterolemia. Am J Obstet Gynecol 2000; 182: 1152-1155
11 Mabuchi H, Sakai Y, Watanabe A, Haba T, Koizumi J, Takeda R. Normalization of low-density lipoprotein levels and disappearance of xanthomas during pregnancy in a woman with heterozygous familial hypercholesterolemia. Metabolism 1985; 34: 309-315
12 Shiomi M, Ito T, Watanabe Y. Increase in hepatic low-density lipoprotein receptor activity during pregnancy in Watanabe heritable hyperlipidemic rabbits; an animal model for familial hypercholesterolemia. Biochim Biophys Acta 1987; 917: 92-100