Abstract Acquired type 3 hyperlipoproteinemia was observed in two patients with systemic lupus erythematosus. In one, the abnormality disappeared after treatment with adrenocortical steroids for seven months. Transient type 3 hyperlipoproteinemia was also observed in a patient with diabetic ketoacidosis. None of the patients had palmar xanthomata. Type 3 hyperlipoproteinemia was not found among ten family members of these three patients, supporting the concept that these patients represent cases of acquired, rather than inherited, type 3 hyperlipoproteinemia. Postheparin lipase activity (PHLA) was decreased in the two patients with systemic lupus erythematosus. In one, PHLA became normal after adrenocortical steroid treatment concomitantly with the disappearance of the type 3 hyperlipoproteinemia. This finding raises the possibility that PHLA deficiency may have played a role in the development of the type 3 hyperlipoproteinemic pattern. References 1. Fredrickson DS, Levy RL, Lees RS: Fat transport in lipoproteins—an integrated approach to mechanisms and disorders. New Eng J Med 276:215-224, 1967.Crossref 2. Fredrickson DS: The regulation of plasma lipoprotein concentration as affected in human mutants. Proc Nat Acad Sci 64:1138-1146, 1969.Crossref 3. Glueck CJ, Levy RI, Glueck HI, et al: Acquired type I hyperlipoproteinemia with systemic lupus erythematosus, dysglobulinemia and heparin resistance. Amer J Med 47:318-324, 1969.Crossref 4. Glueck CJ, Kaplan AP, Levy RI, et al: A new mechanism of exogenous hyperglyceridemia. Ann Intern Med 71:1051-1062, 1969.Crossref 5. Serum cholesterol procedure N-24a and serum triglyceride procedure N-70 , in Technicon Laboratory Method File . Chauncey, NY, Technicon Instrument Corporation, 1968. 6. Fredrickson DS, Ono K, Davis LL: Lipolytic activity of post-heparin plasma in hyperglyceridemia. J Lipid Res 4:24-33, 1963. 7. Noble RP: Electrophoretic separation of plasma lipoproteins in agarose gel. J Lipid Res 9:693-700,1968. 8. Plasma glucose procedure N-9 , in AutoAnalyzer Manual . Chauncey, NY, Technicon Instrument Corporation, 1964. 9. Hales CM, Randle PJ: Immunoassay of insulin with insulin-antibody precipitate. Biochem J 88:137-146, 1963. 10. Hazzard WR, Bierman EL: The impact of hypothyroidism upon clinical expression of broad beta disease (type III hyperlipoproteinemia), abstracted. Clin Res 19:187, 1971. 11. Wintrobe MM, Thorn GW, Adams RD, et al (eds): Harrison's Principles of Internal Medicine , ed 6. New York, McGraw-Hill Book Co Inc, 1970, p 634. 12. Wood PDS, Stern MP, Silvers A, et al: The prevalence of plasma lipid abnormalities in men and women of the Central Valley, California. Circulation 45:114-126, 1972.Crossref 13. Robinson DS: Clearing factor lipase activity of adipose tissue , in Renold AE, Cahill GF (eds): Handbook of Physiology , Washington, DC, American Physiological Society, 1965, section 5, pp 295-299. 14. Bagdade JD, Porte D, Bierman EL: Diabetic lipemia, a form of acquired fat-induced lipemia. New Eng J Med 276:427-433, 1967.Crossref 15. Bagdade JD, Porte D, Bierman EL: Steroid-induced lipemia: A complication of high-dosage corticosteroid therapy. Arch Intern Med 125:129-134, 1970.Crossref 16. Greenberger NJ, Hatch FT, Drummer GD, et al: Pancreatitis and hyperlipemia: A study of serum lipid alterations in 25 patients with acute pancreatitis. Medicine 45:161-174, 1966.Crossref 17. Porte D, O'Hara DD, Williams RH: The relationship between post-heparin lipolytic activity and plasma triglyceride in myxedema. Metabolism 15:107-113, 1966.Crossref 18. Bagdade JD, Porte D, Bierman EL: Acute insulin withdrawal and the regulation of plasma triglyceride removal in diabetic subjects. Diabetes 17:127-132, 1968. 19. Quarfordt S, Levy RI, Fredrickson DS: On the lipoprotein abnormality in type III hyperlipoproteinemia. J Clin Invest 50:754-761, 1971.Crossref 20. Hazzard WR, Bierman EL: Impaired removal of very low density lipoprotein (VLDL) "remnants" in the pathogenesis of broad-beta disease type III hyperlipoproteinemia), abstracted. Clin Res 19:476, 1971.
Archives of Internal Medicine – American Medical Association
Published: Dec 1, 1972