Xantoma y ateroma, hipercolesterolemia familiar homo y heterocigota: riesgo de infarto precoz / Xanthoma and atheroma, homo and heterozygous familiar hypercholesterolemia: risk of early myocardiac infarct

Se presentan dos pacientes con hipercolesterolemia familiar y xantomas en cada una de sus variantes genéticas: homocigota y heterocigota. Se hace revisión y actualización de ambos cuadros: clínica, dermatológica, histopatológica, de laboratorio, por ultrasonografía, genética y terapéutica, destacando la importancia del dignóstico precoz a través de xantoma; para la prevención y el tratamiento oportuno de enfermedades cardiovasculares graves

Effects of a vegetarian diet vs. a vegetarian diet enriched with avocado in hypercholesterolemic patients

To determine the effects of a vegetarian diet with avocado as a source of monounsaturated fat on serum lipids, thirteen patients with phenotype II (twelve with IIa and one with IIb) dyslidipidemia were included in a prospective, transversal and comparative study in chich three four-week diets randomly assigned were assessed. One vegetarian diet (ALVD) was composed of 70 percent carbohydrates, 10 percent proteins and 20 percent lipids. another was composed of 60 percent carbohydrates, 10 percent proteins and 30 percent lipids, 75 percent of which was supplied by avocado (AVD). A third diet was an avocado-added free diet (FDWA). Body wight, body mass index (BMI), and serum lipids (total cholesterol (TC), high (HDL) and low density lipoprotein (LDL) cholesterol and triglycerides (TG) were evaluated. AVD produced a significant decrease in LDL. ALVD did not change TC and LDL, while FDWA increased them slightly. The three diets reduced TG levels, but only ALVD did so significantly. All three diets reduced HDL levels, particularly ALDV, which produced the greatest reduction. Low-fat carbohydrate-rich vegetarian diets may be harmful to hypercholesterolemic patients. The avocado addition to a vegetarian diet does not correct these undesirable effects. To obtain beneficial effects on lipid profiel with avocado, lower amounts of carbohydrates and polyunsaturated fatty acids are probably needed

A propósito de un caso clínico de hiperlipoproteinemia tipo II A en un preescolar / Apropos of a clinical case of hyperlipoproteinemia type II in a preschool child

Se presenta el caso de un niño de 4 años de edad con hipercolesterolemia familiar. Desde los 3 años de edad presentó aparición progresiva de xantomas múltiples. No existieron signos clínicos o alteraciones de laboratorio entre sus parientes. El diagnóstico se sospechó por los síntomas clínicos y se confirmó por el patrón electroforético de las lipoproteínas y la hipercolesterolemia. Se excluyeron las etiologías secundarias de hipercolesterolemia. Con el tratamiento de ejercicios, dieta y ProbucolR, descendió parcialmente, el colesterol total con mantención de los niveles plasmáticos del LDL. Se discute el tipo de herencia, el tratamiento y el pronóstico