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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hyperlipidaemia has become generally accepted as a cause of coronary artery atherosclerosis, arterial occlusion and subsequent myocardial infarction. This may be true in a few people with lipid intolerance, but for the majority, hyperlipidaemia represents a normal physiological response to another pathological process. One such disease process involves the vessel wall, which appears to suffer injury. The cause of the injury may be associated with abnormal movement in the wall and this in turn can be provoked by stress. A hypothesis encompassing these observations is proposed. It would therefore appear that hyperlipidaemia is not a cause of arterial disease, but as part of normal homeostasis, it can be a risk indicator. It is dangerous to consider hyperlipidaemia as a cause of myocardial infarction as this leads to inappropriate treatment. The lowering of cholesterol and low density lipoproteins (LDL) by any means other than sensible dieting may be likened to attempts to lower elevated white blood cell counts in cases of bacterial pneumonia, without treating the pneumonia.
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PMID:Hyperlipidaemia and atherogenesis. 229 87

The authors present the results of examining the plasma lipids in 62 children with an infectious neurotoxic syndrome. The children were suffering from acute respiratory viral infections, lobular pneumonia, or intestinal infections. Hyperlipidemia and dysphospholipidemia were revealed: the former was due primarily to a rise of the content of non-saturated fatty acids and triglycerides, and the latter to a drop of the lecithin and cephaline levels. These changes correlated with the disease gravity. No substantial differences in the plasma lipid spectrum were revealed in the children with the neurotoxicoses due to the acute respiratory infections, pneumonias, and intestinal infections, however, in the latter cases a more marked rise of the triglyceride content was noted.
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PMID:[Clinico-biochemical parallels in neurotoxicoses in children]. 685 98

Out of 26 patients with acute pancreatitis, 8 had several signs of bacterial infection such as high nitroblue tetrazolium (NBT) reduction of granulocytes, fever, elevated ESR and leukocytosis with granulocytosis. 2 patients had a high NBT-value without all other clinical signs of infection and 6 had such signs without a high NBT-value. --An NBT-value lower than normal was found in 6 patients, 3 of whom also had other signs of infection. The level of serum lipids, determined in only 3 of the 6, demonstrated concomitant hypertriglyceridemia. Hyperlipidemia is known to decrease granulocyte activity and might have prevented a stimulation to increased NBT-reduction otherwise brought about by bacterial infection. Further, 3 of the 6 patients with low NBT-reductions suffered from a very severe type of pancreatitis and two of them developed pneumonia. --Bacterial infection may thus contribute to a severe clinical course of pancreatitis, especially in patients with hypertriglyceridemia in whom the granulocyte function is depressed.
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PMID:Granulocyte-function in pancreatitis. Nitroblue tetrazolium-test related to clinical signs of bacterial infection and to hypertriglyceridemia. 693 88

The examination of 54 patients with acute leukemia (AL) found out ambiguous changes in plasmic lipid spectrum typical for elderly patients. Hypocholesterolemia occurred more frequently in nonlymphoblastic AL, is accompanied with severe anemia and infectious-septic complications. Hyperlipidemia was more common among senile AL patients with coronary heart disease which contributed to circulatory failure, cardiac arrhythmia, pneumonia complications and eventually to shorter survival of AL patients.
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PMID:[Plasma lipid spectrum in acute leukemia]. 830 4

To investigate the possible role of previous medical history and previous medications as risk factors for hairy cell leukaemia (HCL) we performed a population based case-control study on 121 male HCL patients and 484 controls. The data were collected through a self-administered mailed questionnaire. Elevated odds ratios (OR) were found for a history of appendicitis [OR 1.9; 95% confidence interval (CI) 0.9-4.2] and pneumonia (OR 2.9; CI 0.9-9.6). We found a reduced risk for HCL associated with a history of myocardial infarction (OR 0.3; CI 0.4-2.5), hypertension (OR 0.6; CI 0.3-1.2) and thromboembolic disease (OR 0.6; CI 0.1-2.7). Reduced OR was also associated to a history of diabetes mellitus (OR 0.6; CI 0.1-2.9) and a diagnosis of hyperlipidemia (OR 0.8; CI 0.2-3.6). HCL is an indolent disease with a clinical course of many years and it can not be excluded that the disease leads to metabolic changes, resulting in a changed risk for these diagnoses. When the role of previous medications were investigated, increased OR was found for NSAID (OR 3.4; CI 1.1-10.2). Decreased OR was found for the anti-coagulative agent warfarin (OR 0.4; CI 0.1-1.5). A history of a previous malignancy preceeding the diagnosis of HCL as reported to the Swedish Cancer Registry yielded an increased OR of 3.2 (CI 1.2-8.5). All results must be interpreted with caution, as there is a possibility of misclassification. Medications is difficults to remember, particularly several years after consumption. As many comparisons were made, there is always a possibility of correlations occuring by chance.
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PMID:Previous medical history and medications as risk factors for hairy cell leukaemia. 1002 13

The management of membranous nephropathy first requires the recognition of whether the disorder is primary (idiopathic) or secondary. Next, a familiarity with its natural history and knowledge of our current capacity to predict those patients with the worst outcome is reviewed. Treatment options of those at risk of progression with immunosuppressive drugs is then discussed along with the required accompaniment of risk reduction strategies including idealization of the blood pressure, the use of angiotensin enzyme inhibitor therapy and perhaps dietary protein restriction. As well treatment directed at other complications of the disease process including the hyperlipidemia and hypercoagulability are considered as part of the management to reduce risks. Lastly, therapies directed towards preventing or reducing the complications of immunosuppressive drugs such as trimethoprim-sulfamethoxazole prophylaxis against pneumocystis carini pneumonia and biphosphonates to reduce bone mass loss from corticosteroid therapy are discussed.
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PMID:Management of membranous nephropathy. 1191 83

Rapamycin/sirolimus (SR), trade named Rapammune (Wyeth-Ayerst, Sydney, Australia), is a potent immunosuppressive drug associated with myelosuppression, hypertension, hyperlipidemia, and infection. Rapamycin/sirolimus-induced pneumonitis has been described previously in renal transplant recipients, and this report describes a stable heart-lung transplant recipient who developed a pulmonary infiltrate that reversed after ceasing SR therapy. We believe that immunosuppression-induced pneumonitis in a lung allograft is a serious dilemma for lung transplant physicians
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PMID:Interstitial pneumonitis associated with sirolimus: a dilemma for lung transplantation. 1258 72

Rapamycin is an immunosuppressive drug with a distinct and unique mode of action and a specific side effect profile. We report here briefly on our personal clinical experience using this immunosuppressive drug in different combinations and settings. Rapamycin is without any doubt an efficient drug capable of preventing acute allograft rejection in a variety of immunosuppressive combinations. It is also a very potent drug that is not devoid of serious side effects. Infectious complications as a result of strong inhibition of the immune system are a frequent cause of hospitalization with severe morbidity and even mortality. Fungal infections and pneumonia are among the most devastating complications. As clinical experience with rapamycin grows and the therapeutic window of the drug can be further narrowed, these infectious complications will improve. Wound healing problems and lymphocoeles form another frequent surgical dilemma and are related to the antiproliferative properties of rapamycin. Last, hyperlipidemia warrants the use of statins in the majority of rapamycin-treated patients and whether this unfavorable side effect will offset the theoretically beneficial cardiovascular effects of the drug remains to be determined in controlled trials with long-term follow-up. Finally, the specific antiproliferative properties of rapamycin and the fact that it exerts no nephrotoxicity make this drug an alternative for calcineurin inhibitors and could make it an ideal candidate for treating chronic allograft dysfunction.
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PMID:Clinical use of rapamycin in renal allograft recipients identifies its relevant toxicity profile and raises unsolved questions: a single-center experience. 1274 86

Hyperlipidemia promotes the chronic inflammatory disease atherosclerosis through poorly understood mechanisms. Atherogenic lipoproteins activate platelets, but it is unknown whether platelets contribute to early inflammatory atherosclerotic lesions. To address the role of platelet aggregation in diet-induced vascular disease, we studied beta3 integrin-deficient mice (lacking platelet integrin alphaIIbbeta3 and the widely expressed nonplatelet integrin alphavbeta3) in two models of atherosclerosis, apolipoprotein E (apoE)-null and low-density lipoprotein receptor (LDLR)-null mice. Unexpectedly, a high-fat, Western-type (but not a low-fat) diet caused death in two-thirds of the beta3-/-apoE-/- and half of the beta3-/-LDLR-/- mice due to noninfectious pneumonitis. In animals from both models surviving high-fat feeding, pneumonitis was absent, but aortic atherosclerosis was 2- to 6-fold greater in beta3-/- compared with beta+/+ littermates. Expression of CD36, CD40L, and CD40 was increased in lungs of beta3-/-LDLR-/- mice. Each was also increased in smooth muscle cells cultured from beta3-deficient mice and suppressed by retroviral reconstitution of beta3. These data show that the platelet defect caused by alphaIIbbeta3 deficiency does not impair atherosclerotic lesion initiation. They also suggest that alphavbeta3 has a suppressive effect on inflammation, the loss of which induces atherogenic mediators that are amplified by diet-induced hyperlipidemia.
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PMID:Beta3 integrin deficiency promotes atherosclerosis and pulmonary inflammation in high-fat-fed, hyperlipidemic mice. 1274 2

Innovations in immunosuppressant therapy often transfer from renal transplantation to heart transplantation. Accordingly, there is growing interest in calcineurin inhibitor (CNI)- and steroid-sparing regimens for heart transplant patients. The novel proliferation signal inhibitor, Certican (everolimus), has been shown to allow reduced CNI exposure in renal transplant recipients without loss of efficacy. It has also demonstrated efficacy for reducing biopsy-proven acute rejection (BPAR) and cardiac allograft vasculopathy (CAV) in de novo heart transplantation. The present study reports early clinical experience of introducing everolimus as maintenance immunosuppression in heart transplant recipients whose previous regimen had failed. A 58-year-old woman received an organ from a 56-year-old female donor. She was prescribed cyclosporine for micromemulsion (CsA; Neoral), azathioprine, prednisolone and atorvastatin. After 3 months, azathioprine was switched to mycophenolate mofetil (MMF). At Month 27, the patient experienced Grade 3A BPAR, had a left ventricular ejection fraction (LVEF) of 20%, and compromised renal function. After steroid boluses to control BPAR, everolimus 3.0 mg/day was prescribed, while CsA and prednisolone doses were reduced. One month later, the patient contracted herpes labialis and pneumonia, and creatinine was elevated; CsA was stopped, everolimus dose was reduced to 1.5 mg/day and prednisolone reduced further. After another month, LVEF recovered to 50% and creatinine was 1.29 mg/dl. There was evidence of hyperlipidemia, which responded to atorvastatin 10 mg. For maintenance immunosuppression after heart transplantation, everolimus may allow CsA dose reduction and could be efficacious in combination with MMF. Further studies are required to confirm its efficacy and effects on CAV.
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PMID:Clinical experience with Certican (everolimus) in maintenance heart transplant patients at the Medical University of Vienna. 1577 24


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