Genetic testing in patients with premature atherosclerosis and hypertriglyceridemia can identify rare genotypes like apolipoprotein E ε2ε1, aiding in the diagnosis and management of familial dysbetalipoproteinemia.
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Highlights potential diagnostic value of ApoE genotyping in premature atherosclerosis with hypertriglyceridemia; leaves open routine adoption pending further evidence.
We present a case of a 40-year-old male with premature atherosclerosis, with evidence of both eruptive and tendinous xanthomas, which could imply an increase in both low-density lipoprotein (LDL) and triglyceride (TG) levels. However, his LDL was 2.08 mmol/l, TG -11.8 mmol/l on rosuvastatin 20 mg. Genetic evaluation was performed using a custom panel consisting of 25 genes and 280 variants responsible for lipid metabolism. A rare ε 2 ε 1 genotype of apolipoprotein E was detected. The combination of clinical manifestations and genetic factors in this patient leads to the diagnosis of familial dysbetalipoproteinemia. Implementation of genetic testing into routine clinical practice could not only improve disease diagnostics and management, but also help prevent their development.
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Лимонова et al. (2021) studied this question.
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