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SERUM LIPOPROTEINS AND CHOLESTEROL METABOLISM IN XANTHELASMA

SERUM LIPOPROTEINS AND CHOLESTEROL METABOLISM IN XANTHELASMA Abstract XANTHELASMA is generally considered to be the commonest external manifestation of essential hypercholesteremic xanthomatosis1 (familial hypercholesteremia2). Major interest in the xanthomatous lesions centers about their importance with respect to the presence or development of atherosclerotic vascular disease. The purpose of this paper is to report observations of 35 patients with xanthelasma, obtained mainly from the private dermatologic practice of one of us (N. N. E.). It was felt of particular importance to study the serum of such patients with respect to lipoproteins which appear to be in some way associated with atherosclerosis. METHODS The clinical status of these patients was carefully investigated and was supplemented by electrocardiograms and by the thymol turbidity and sulfobromophthalein (bromsulphalein®) sodium tests of liver function. All patients with nonxanthomatous abnormalities known to be associated with a disturbed cholesterol metabolism were excluded. Particular attention was given to the possible presence of manifest arteriosclerotic cardiovascular disease. Quantitative analysis of References 1. Thannhauser, S. J.: Lipidoses: Diseases of the Cellular Lipid Metabolism , ed. 2, New York, Oxford University Press, 1950. 2. Boas, E. P.; Parets, A. D., and Adlersberg, D.: Hereditary Disturbance of Cholesterol Metabolism , Am. Heart J. 35:611, 1948.Crossref 3. Adlersberg, D.; Parets, A. D., and Boas, E. P.: Genetics of Atherosclerosis , J. A. M. A. 141:246 ( (Sept. 24) ) 1949.Crossref 4. Montgomery, H., and Osterberg, A. I.: Xanthomatosis: Correlation of Clinical, Histopathologic and Chemical Studies of Cutaneous Xanthoma , Arch. Dermat. & Syph. 37:373 ( (March) ) 1938. 5. Wilkinson, C. F., Jr.; Band, E. A., and Fliegelman, M. J.: Essential Familial Hypercholesterolemia , Ann. Int. Med. 29:671, 1948. 6. Boas, E. P., and Adlersberg, D.: Familial Hypercholesterolemia (Xanthomatosis and Atherosclerosis) , J. Mt. Sinai Hosp. 12:84, 1945. 7. Saifer, A., and Kammerer, O. F.: Photometric Determination of Total Cholesterol in Plasma or Serum by Modified Liebermann-Burchard Reaction , J. Biol. Chem. 164:657, 1946. 8. Byers, S. O., and Friedman, M.: Hypercholesteremia in the Rat After Intravenous Administration of Cholesterol , J. Biol. Chem. 177:841, 1949. 9. Gofman, J. W.: The Role of Lipids and Lipoproteins in Atherosclerosis , Science 111:166, 1950 10. Gofman, J. W.; Jones, H. B.; Lindgren, F. T.; Lyon, L. P.; Elliott, H. A., and Strisower, B.: Blood Lipids and Human Atherosclerosis , Circulation 2:161, 1950 11. Montgomery, H.: Xanthomatosis: Cutaneous Xanthoma, Especially in Relation to Diseases of Liver , J. Invest. Dermat. 1:325, 1938 12. Xanthomatosis: A Systemic Disease , Proc. Staff Meet., Mayo Clin. 12:641, 1937 13. Cutaneous Xanthomatosis , Ann. Int. Med. 13:671, 1939 14. Cutaneous Manifestations of Diseases of Lipoid Metabolism , M. Clin. North America 24:1249, 1940. 15. Thannhauser.1a Thannhauser, S. J., and Magendantz, H.: The Different Clinical Groups of Xanthomatous Diseases: A Clinical Study of 22 Cases , Ann. Int. Med. 11:1662, 1938. 16. Thannhauser, S. J.: Cholesterol Metabolism and the Different Groups of Xanthomatous Diseases, Proc. California Acad. Med., 1937-1938, p. 97. 17. Sperry, W. M.: The Biochemistry of the Lipoidoses , J. Mt. Sinai Hosp. 9:799, 1942. 18. Müller, C.: Angina Pectoris in Hereditary Xanthomatosis , Arch. Int. Med. 64:675 ( (Oct.) ) 1939 19. Acta med scandinav . (supp. 89) , p. 75, 1938 20. Footnote 1. Footnote 2b. 21. Fliegelman, M. T.; Wilkinson, C. F., and Band, E. A.: Genetics of Xanthoma Tuberosum Multiplex , Arch. Dermat. & Syph. 58:409 ( (Oct.) ) 1948. 22. Thannhauser.1a Adlersberg, Parets, and Boas.1c Müller.9b Fliegelman, Wilkinson, and Band.11b 23. Adlersberg, Parets, and Boas.1c Müller.9b Fliegelman, Wilkinson, and Band.11b 24. Footnote 1a, b and c. 25. Curtis, A. C., and Berger, J. P.: Effect of Feeding a Liprotic Substance to Patients with Xanthelasma , Arch. Dermat. & Syph. 52:252 ( (Oct.) ) 1945. 26. Wilkinson, C. F.: Blecha, E., and Reimer, A.: Is There a Relation Between Diet and Blood Cholesterol? Arch. Int. Med. 85:389 ( (March) ) 1950 27. Sperry, W. M., and Schick, B.: Essential Xanthomatosis: Treatment with CholesterolFree Diet in 2 Cases , Am. J. Dis. Child. 51:1372 ( (June) ) 1936. 28. Thannhauser.1a Sperry and Schick.16c 29. Footnote 1a, b, and c. Footnote 8c. 30. Thannhauser.1a Montgomery.6c Müller.9b 31. Thannhauser.1a Montgomery.6c Montgomery and Osterberg.1d Müller.9b 32. (a) Footnotes 6c and d, and 15b. (b) Montgomery, H., in discussion on Wilkinson.16b 33. Footnote 1b and c. Footnote 16c. 34. Footnote la, b, and c. Footnote 6d. Footnote 9b. Footnote 21b. 35. Footnote 6c and d. Footnote Id. 36. Footnote lb and c. 37. Rigdon, R. H., and Willeford, G.: Sudden Death During Childhood with Xanthoma Tuberosum , J. A. M. A. 142:1268 ( (April 22) ) 1950.Crossref 38. McKinney, P. P.: Xanthoma Palpebrarum and Cardiovascular Disease , Brit. M. J. 2:1259, 1950.Crossref 39. Footnotes 1b, c, and d. 40. Walin, C.: Coronary Artery Sclerosis as Symptom of Xanthomatosis , Acta med. scandinav. 134:53, 1949.Crossref 41. Footnote la and b. Footnote 9b. 42. Keys, A.; Michelson, O.; Miller, E. V., and Chapman, C. B.: The Relation in Man Between Cholesterol Levels in the Diet and in the Blood , Science 112:79, 1950.Crossref 43. Sperry.8b Sperry and Schick.16c Montgomery.21b 44. Gofman, J. W.; Jones, H. B.; Lindgren, E. T.; Lyon, T. P.; Elliott, H. A., and Strishower, B.: Blood Lipids and Human Atherosclerosis , Circulation 2:161, 1950.Crossref 45. Gofman and others.32 Keys and others.30b 46. Wilkinson, C. F.: Essential Familial Hypercholesterolemia: Cutaneous, Metabolic and Hereditary Aspects , Bull. New York Acad. Med. 26:670, 1950. 47. Curtis, A. C.; Wile, U. J., and Eckstein, H. C.: Involution of Cutaneous Xanthomata Caused by Diets Low in Calories , J. Clin. Invest. 7:249, 1929.Crossref 48. Adlersberg, D., and Sobotka, H.: Effect of Prolonged Lecithin Feeding on Hyperchlesterolemia , J. Mt. Sinai Hosp. 9:955, 1943. 49. Delevett, A. F., and Bruger, M.: Plasma Lipids in Primary and Secondary Hypercholesteremia: Effect of Lipotropic Substances , Arch. Int. Med. 81:859 ( (June) ) 1948.Crossref 50. Footnote 1b and c. Footnote 11b. Footnote 16b. 51. Thannhauser.1a Fliegelman, Wilkinson, and Band.11b 52. Footnote 1a, b, and c. Footnote 2a. Footnote 11b. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Dermatology & Syphilology American Medical Association

SERUM LIPOPROTEINS AND CHOLESTEROL METABOLISM IN XANTHELASMA

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American Medical Association
Copyright
Copyright © 1952 American Medical Association. All Rights Reserved.
ISSN
0096-5979
DOI
10.1001/archderm.1952.01530200074011
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Abstract

Abstract XANTHELASMA is generally considered to be the commonest external manifestation of essential hypercholesteremic xanthomatosis1 (familial hypercholesteremia2). Major interest in the xanthomatous lesions centers about their importance with respect to the presence or development of atherosclerotic vascular disease. The purpose of this paper is to report observations of 35 patients with xanthelasma, obtained mainly from the private dermatologic practice of one of us (N. N. E.). It was felt of particular importance to study the serum of such patients with respect to lipoproteins which appear to be in some way associated with atherosclerosis. METHODS The clinical status of these patients was carefully investigated and was supplemented by electrocardiograms and by the thymol turbidity and sulfobromophthalein (bromsulphalein®) sodium tests of liver function. All patients with nonxanthomatous abnormalities known to be associated with a disturbed cholesterol metabolism were excluded. Particular attention was given to the possible presence of manifest arteriosclerotic cardiovascular disease. Quantitative analysis of References 1. Thannhauser, S. J.: Lipidoses: Diseases of the Cellular Lipid Metabolism , ed. 2, New York, Oxford University Press, 1950. 2. Boas, E. P.; Parets, A. D., and Adlersberg, D.: Hereditary Disturbance of Cholesterol Metabolism , Am. Heart J. 35:611, 1948.Crossref 3. Adlersberg, D.; Parets, A. D., and Boas, E. P.: Genetics of Atherosclerosis , J. A. M. A. 141:246 ( (Sept. 24) ) 1949.Crossref 4. Montgomery, H., and Osterberg, A. I.: Xanthomatosis: Correlation of Clinical, Histopathologic and Chemical Studies of Cutaneous Xanthoma , Arch. Dermat. & Syph. 37:373 ( (March) ) 1938. 5. Wilkinson, C. F., Jr.; Band, E. A., and Fliegelman, M. J.: Essential Familial Hypercholesterolemia , Ann. Int. Med. 29:671, 1948. 6. Boas, E. P., and Adlersberg, D.: Familial Hypercholesterolemia (Xanthomatosis and Atherosclerosis) , J. Mt. Sinai Hosp. 12:84, 1945. 7. Saifer, A., and Kammerer, O. F.: Photometric Determination of Total Cholesterol in Plasma or Serum by Modified Liebermann-Burchard Reaction , J. Biol. Chem. 164:657, 1946. 8. Byers, S. O., and Friedman, M.: Hypercholesteremia in the Rat After Intravenous Administration of Cholesterol , J. Biol. Chem. 177:841, 1949. 9. Gofman, J. W.: The Role of Lipids and Lipoproteins in Atherosclerosis , Science 111:166, 1950 10. Gofman, J. W.; Jones, H. B.; Lindgren, F. T.; Lyon, L. P.; Elliott, H. A., and Strisower, B.: Blood Lipids and Human Atherosclerosis , Circulation 2:161, 1950 11. Montgomery, H.: Xanthomatosis: Cutaneous Xanthoma, Especially in Relation to Diseases of Liver , J. Invest. Dermat. 1:325, 1938 12. Xanthomatosis: A Systemic Disease , Proc. Staff Meet., Mayo Clin. 12:641, 1937 13. Cutaneous Xanthomatosis , Ann. Int. Med. 13:671, 1939 14. Cutaneous Manifestations of Diseases of Lipoid Metabolism , M. Clin. North America 24:1249, 1940. 15. Thannhauser.1a Thannhauser, S. J., and Magendantz, H.: The Different Clinical Groups of Xanthomatous Diseases: A Clinical Study of 22 Cases , Ann. Int. Med. 11:1662, 1938. 16. Thannhauser, S. J.: Cholesterol Metabolism and the Different Groups of Xanthomatous Diseases, Proc. California Acad. Med., 1937-1938, p. 97. 17. Sperry, W. M.: The Biochemistry of the Lipoidoses , J. Mt. Sinai Hosp. 9:799, 1942. 18. Müller, C.: Angina Pectoris in Hereditary Xanthomatosis , Arch. Int. Med. 64:675 ( (Oct.) ) 1939 19. Acta med scandinav . (supp. 89) , p. 75, 1938 20. Footnote 1. Footnote 2b. 21. Fliegelman, M. T.; Wilkinson, C. F., and Band, E. A.: Genetics of Xanthoma Tuberosum Multiplex , Arch. Dermat. & Syph. 58:409 ( (Oct.) ) 1948. 22. Thannhauser.1a Adlersberg, Parets, and Boas.1c Müller.9b Fliegelman, Wilkinson, and Band.11b 23. Adlersberg, Parets, and Boas.1c Müller.9b Fliegelman, Wilkinson, and Band.11b 24. Footnote 1a, b and c. 25. Curtis, A. C., and Berger, J. P.: Effect of Feeding a Liprotic Substance to Patients with Xanthelasma , Arch. Dermat. & Syph. 52:252 ( (Oct.) ) 1945. 26. Wilkinson, C. F.: Blecha, E., and Reimer, A.: Is There a Relation Between Diet and Blood Cholesterol? Arch. Int. Med. 85:389 ( (March) ) 1950 27. Sperry, W. M., and Schick, B.: Essential Xanthomatosis: Treatment with CholesterolFree Diet in 2 Cases , Am. J. Dis. Child. 51:1372 ( (June) ) 1936. 28. Thannhauser.1a Sperry and Schick.16c 29. Footnote 1a, b, and c. Footnote 8c. 30. Thannhauser.1a Montgomery.6c Müller.9b 31. Thannhauser.1a Montgomery.6c Montgomery and Osterberg.1d Müller.9b 32. (a) Footnotes 6c and d, and 15b. (b) Montgomery, H., in discussion on Wilkinson.16b 33. Footnote 1b and c. Footnote 16c. 34. Footnote la, b, and c. Footnote 6d. Footnote 9b. Footnote 21b. 35. Footnote 6c and d. Footnote Id. 36. Footnote lb and c. 37. Rigdon, R. H., and Willeford, G.: Sudden Death During Childhood with Xanthoma Tuberosum , J. A. M. A. 142:1268 ( (April 22) ) 1950.Crossref 38. McKinney, P. P.: Xanthoma Palpebrarum and Cardiovascular Disease , Brit. M. J. 2:1259, 1950.Crossref 39. Footnotes 1b, c, and d. 40. Walin, C.: Coronary Artery Sclerosis as Symptom of Xanthomatosis , Acta med. scandinav. 134:53, 1949.Crossref 41. Footnote la and b. Footnote 9b. 42. Keys, A.; Michelson, O.; Miller, E. V., and Chapman, C. B.: The Relation in Man Between Cholesterol Levels in the Diet and in the Blood , Science 112:79, 1950.Crossref 43. Sperry.8b Sperry and Schick.16c Montgomery.21b 44. Gofman, J. W.; Jones, H. B.; Lindgren, E. T.; Lyon, T. P.; Elliott, H. A., and Strishower, B.: Blood Lipids and Human Atherosclerosis , Circulation 2:161, 1950.Crossref 45. Gofman and others.32 Keys and others.30b 46. Wilkinson, C. F.: Essential Familial Hypercholesterolemia: Cutaneous, Metabolic and Hereditary Aspects , Bull. New York Acad. Med. 26:670, 1950. 47. Curtis, A. C.; Wile, U. J., and Eckstein, H. C.: Involution of Cutaneous Xanthomata Caused by Diets Low in Calories , J. Clin. Invest. 7:249, 1929.Crossref 48. Adlersberg, D., and Sobotka, H.: Effect of Prolonged Lecithin Feeding on Hyperchlesterolemia , J. Mt. Sinai Hosp. 9:955, 1943. 49. Delevett, A. F., and Bruger, M.: Plasma Lipids in Primary and Secondary Hypercholesteremia: Effect of Lipotropic Substances , Arch. Int. Med. 81:859 ( (June) ) 1948.Crossref 50. Footnote 1b and c. Footnote 11b. Footnote 16b. 51. Thannhauser.1a Fliegelman, Wilkinson, and Band.11b 52. Footnote 1a, b, and c. Footnote 2a. Footnote 11b.

Journal

A.M.A. Archives of Dermatology & SyphilologyAmerican Medical Association

Published: Jan 1, 1952

References