Severe hypercholesterolemia due to the cholestatic form of acute graft-versus-host disease with liver damage in a child following allogeneic hematopoietic stem cell transplantation

Hypercholesterolemia is one of the complications of allogeneic hematopoietic stem cell transplantation. Various factors may contribute to its etiology, including graft-versus-host disease (GVHD) of the liver. This publication presents a clinical case of severe hypercholesterolemia associated with acute GVHD with the liver involvement in a patient with Nijmegen syndrome. The patient's parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications. A high level of lipoprotein X was detected by peripheral blood electrophoresis and subsequent typing. This laboratory phenomenon is a characteristic manifestation of dyslipidaemia associated with cholestasis accompanying the hepatic form of GVHD. Clinical improvement and a reduction of cholesterol levels were achieved after intensification of immunosuppressive therapy. This clinical case highlights the necessity for early recognition and differential assessment of severe hypercholesterolemia in patients following allogeneic hematopoietic stem cell transplantation.