The changes in plasma lipoproteins in a case of heterozygous familial hypercholesterolemia after plasmapheresis.

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Abstract
The changes in plasma lipoproteins after plasmapheresis were estimated in a case of heterozygous familial hypercholesterolemia. Two and a half liters of plasma were exchanged with the same volume of Plasmanate. The effects of cholestyramine on the changes in plasma lipoproteins were also studied after the 2nd plasmapheresis. Fasting plasma was collected serially, and plasma VLDL [very low density lipoprotein], IDL [intermediate density lipoprotein], LDL1 [low density lipoprotein] (1.019 < d < 1.045), LDL2 (1.045 < d < 1.063), HDL2 [high density lipoprotein 2] (1.063 < d < 1.125) and HDL3 (d > 1.125) were separated by ultracentrifugation. The cholesterol and apoprotein contents in these lipoprotein fractions were analyzed. Apoprotein AI, AII, B, CII and E were measured by single radial immunodiffusion. VLDL-C and plasma apoprotein CII and E incrased very rapidly. The LDL-C increase was slightly slower than that of VLDL-C. LDL1-C continued to increase for 3 wk, but LDL2-C reached a plateau around 1 wk after plasmapheresis and declined thereafter. The change of apoprotein B was similar to that of cholesterol in VLDL, IDL, LDL1 and LDL2. Cholesterol amounts in HDL2 and HDL3 changed in a parallel manner, as did apoprotein AI and AII. HDL2 reached their preplasmapheresis levels in 1 wk. Cholestyramine did not inhibit the increase of VLDL, IDL, LDL1 or LDL2 in this case.

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