Long-term administration of the HMG-CoA reductase inhibitor lovastatin in two patients with cholesteryl ester storage disease
F. Rassoul1, V. Richter1, P. Lohse2, A. Naumann1, K. Purschwitz1, E. Keller3
1 Department of Clinical Chemistry and Pathobiochemistry, University Leipzig/Working Group Health Promotion and Prevention of Atherosclerosis (AGA) Leipzig, 2 Department of Clinical Chemistry, Großhadern Clinic, Ludwig Maximilians University, München, and 3 Clinic of Pediatrics, University Leipzig, Germany
DOI 10.5414/CPP39199
Abstract
Objective: In order to suppress de novo cholesterol and VLDL biosynthesis, a long-term therapy trial with lovastatin, a competitive inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, was initiated in two patients with cholesteryl ester storage disease (CESD), and concentrations of plasma lipids were monitored over a period of 9 years. Methods: We studied two male patients with enzymatically confirmed CESD in whom long-term lovastatin therapy (8 and 9 years) was begun at the age of 7 and 19 years. The diagnosis of CESD was confirmed by the measurement of human lysosomal acid lipase (hLAL) activity in cultured skin fibroblasts and leukocytes. Restriction fragment length polymorphism (RFLP) analysis revealed that both subjects are homozygotes for the common CESD splice site mutation. Levels of serum lipids and lipoproteins were measured yearly. Results: During the first year, total serum cholesterol decreased from 317 to 201 mg/dl in Patient A and from 228 to 120 mg/dl in Patient B, due mainly to the reduction of low-density lipoprotein (LDL) cholesterol from 262 to 151 mg/dl in Patient A and from 166 to 66 mg/dl in Patient B. Accordingly, the LDL cholesterol : high density lipoprotein (HDL) cholesterol ratio was markedly reduced in both patients after one year of therapy. The treatment was continued and, after 9 years of further medication, low total cholesterol and LDL cholesterol levels were still maintained. Conclusions: The study demonstrates that HMG-CoA reductase inhibitors are well tolerated drugs during long-term treatment of CESD patients and may help to prevent the development of premature atherosclerosis.
Author Details
Authors
Departments
- 1 Department of Clinical Chemistry and Pathobiochemistry, University Leipzig/Working Group Health Promotion and Prevention of Atherosclerosis (AGA) Leipzig,
- 2 Department of Clinical Chemistry, Großhadern Clinic, Ludwig Maximilians University, München, and
- 3 Clinic of Pediatrics, University Leipzig, Germany
Address
Dr. F. Rassoul; Department of Clinical Chemistry and Pathobiochemistry, University Leipzig, Liebigstraße 27, D-04103 Leipzig, Germany
Email:
[email protected]
Citation
F. Rassoul, V. Richter, P. Lohse, A. Naumann, K. Purschwitz and E. Keller.Long-term administration of the HMG-CoA reductase inhibitor lovastatin in two patients with cholesteryl ester storage disease. 2001; 39: 199-204. doi: 10.5414/CPP39199.
