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Hypercholesterolemia Persisting After Distal Ileal Bypass: Response to Mevinolin
- D. ROGER ILLINGWORTH, M.D., Ph.D.; and
- WILLIAM E. CONNOR, M.D.
Excerpt
Familial hypercholesterolemia is an autosomal dominant disorder associated with lifelong hypercholesterolemia and premature atherosclerosis (1). Treatment of patients heterozygous for this disorder has included diet, medications (colestipol, nicotinic acid, probucol) (2), and in certain patients surgical bypass of the distal ileum (3). By selectively removing the site of bile acid reabsorption, distal ileal bypass surgery results in enhanced fecal excretion of bile acids; an increased rate of hepatic conversion of cholesterol to bile acids; and, by depleting the hepatic pool of cholesterol, an increase in the number of high-affinity receptors for low-density lipoproteins (LDL) on hepatocyte membranes with a concomittant
This 100-word excerpt has been provided in the absence of an abstract.
Acknowledgments
ACKNOWLEDGMENTS: The authors thank Dr. J. A. Tobert, Merck, Sharp & Dohme, Rahway, New Jersey, for supplying the mevinolin, and Dr. David Calder for the referral of this patient.
Article and Author Information
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Grant support: in part by grant HL29074 from the Public Health Service, and grant RR334 from the General Clinical Research Centers Program. Dr. Illingworth is the recipient of Research Career Development Award HL00953 from the National Institutes of Health.
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▸Requests for reprints should be addressed to D. Roger Illingworth, M.D., Ph.D.; Department of Medicine, L465, The Oregon Health Sciences University; Portland, OR 97201.
