Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec:26 Suppl 1:89-96.
doi: 10.1111/1744-9987.13841. Epub 2022 Dec 5.

Pregnancy in homozygous familial hypercholesterolemia-A case series

Milan Bláha  1 , Kateřina Veletová  2 , Vladimír Blaha  2 , Miriam Lánská  1 , Pavel Žák  1
Affiliations

Pregnancy in homozygous familial hypercholesterolemia-A case series

Milan Bláha et al. Ther Apher Dial. 2022 Dec.

Abstract

Introduction: Familial hypercholesterolemia (FH) is an autosomal codominant lipid metabolism disorder. It results in lifelong elevation of plasmatic low-density lipoprotein cholesterol (LDL-C) levels, followed by premature atherosclerosis. In women, pregnancy and lactation represent an additional risk due to association of physiological changes, pre-existing dyslipidemia, and limited therapeutic possibilities and experiences. Methods of extracorporeal LDL-apheresis represent a suitable therapeutic approach.

Case series: We present our experience in case reports of six HoFH women and their 13 pregnancies (nine successful, three abortions, and one interruption). One patient experienced a lethal complication of her pregnancy. Of the nine successful pregnancies, two cases were treated by LDL-apheresis.

Conclusion: Pregnancy in HoFH women represents substantial risk; however, patients without signs of decompensated cardiovascular disease can have a good prognosis. LDL-apheresis plays an important role in the management of pregnancy in HoFH.

Keywords: LDL-apheresis; atherosclerosis; cardiovascular disease; homozygous familial hypercholesterolemia; pregnancy.

PubMed Disclaimer

References

REFERENCES

    1. Harada-Shiba M, Arai H, Ishigaki Y, Ishibashi S, Okamura T, Ogura M, et al. Guidelines for diagnosis and treatment of familial hypercholesterolemia 2017. J Atheroscler Thromb. 2018;25(8):751-70. https://doi.org/10.5551/jat.CR003
    1. Sanchez-Hernandez RM, Civeira F, Stef M, Perez-Calahorra S, Almagro F, Plana N, et al. Homozygous familial hypercholesterolemia in Spain: prevalence and phenotype-genotype relationship. Circ Cardiovasc Genet. 2016;9(6):504-10. https://doi.org/10.1161/CIRCGENETICS.116.001545
    1. Amundsen AL, Khoury J, Iversen PO, Bergei C, Ose L, Tonstad S, et al. Marked changes in plasma lipids and lipoproteins during pregnancy in women with familial hypercholesterolemia. Atherosclerosis. 2006;189(2):451-7. https://doi.org/10.1016/j.atherosclerosis.2006.01.002
    1. Tummala L, Agrawal A, Lundberg G. Management considerations for lipid disorders during pregnancy. Curr Treat Options Cardiovasc Med. 2021;23:50. https://doi.org/10.1007/s11936-021-00926-1
    1. Blaha M, Lanska M, Blaha V, Boudys L, Zak P. Pregnancy in homozygous familial hypercholesterolemia - importance of LDL-apheresis. Atheroscler Suppl. 2015;18:134-9. https://doi.org/10.1016/j.atherosclerosissup.2015.02.024

MeSH terms

LinkOut - more resources