RESUMO
Six patients with heterozygous familial hypercholesterolemia [FH] [age range 49-59 years] and 10 healthy controls were studied. Diagnosis of FH in this group of patients upon the presence of a history of ischemic heart disease [IHD] started at an early age, tendon xanthoma, strong family history of IHD and raised plasma total cholesterol above 386 mg/dL and low density lipoprotein cholesterol [LDLc] above 190 mg/L. All patients were refractory to diet and drug treatment. Plasma exchange [PE] on seven separate occasions reduced significantly the level of LDL-c with a rise in HDL-c during the first two hours of PE, and reached the baseline in 3 days. However, long term PE, after several weeks does not normalize the level of HDL-c. Using selective LDL-c filtration procedure, in which LDL-c fraction was removed by membrane filtration over a poly alcohol filter, LDL-c was reduced by about 50% and HDL-c was increased by about 60%. Both PE and selective filtration are successful methods of treatment of heterozygous FH