Xanthomatous Pseudospectacles in Familial Hypercholesterolemia
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《新英格兰医药杂志》
A 40-year-old woman presented with exertional chest pain and was found to have familial hypercholesterolemia (type IIa) and severe three-vessel coronary artery disease. Xanthoma palpebrarum was noted on physical examination, manifested as pseudospectacles (Panel A). The patient also had associated tuberous xanthomas of tumorous proportion on the buttocks, hands, and feet (Panels B and C). Her lipid profile revealed the following levels: total cholesterol, 550 mg per deciliter (14.22 mmol per liter); triglycerides, 180 mg per deciliter (2.03 mmol per liter); high-density lipoprotein cholesterol, 34 mg per deciliter (0.88 mmol per liter); and low-density lipoprotein cholesterol, 480 mg per deciliter (12.41 mmol per liter).
Xanthomas are an important manifestation of altered lipid metabolism. Morbidity and mortality that are associated with the condition are related to atherosclerotic disease. Tuberous xanthomas are small, firm, painless nodules of a reddish yellow color that can coalesce to form multilobated tumors. They usually develop in pressure areas and are associated with increased levels of low-density lipoprotein cholesterol.
M.P. Girish, M.D.
Mohit Dayal Gupta, M.D.
G.B. Pant Hospital
New Delhi, India 110002
Xanthomas are an important manifestation of altered lipid metabolism. Morbidity and mortality that are associated with the condition are related to atherosclerotic disease. Tuberous xanthomas are small, firm, painless nodules of a reddish yellow color that can coalesce to form multilobated tumors. They usually develop in pressure areas and are associated with increased levels of low-density lipoprotein cholesterol.
M.P. Girish, M.D.
Mohit Dayal Gupta, M.D.
G.B. Pant Hospital
New Delhi, India 110002