Key result
LDL apheresis safely and successfully treats heterozygous familial hypercholesterolemia throughout pregnancy to delivery.
Why the study?
Effective treatment options for managing elevated LDL-C in pregnant women with familial hypercholesterolemia are limited due to contraindications of statins, and LDL apheresis methods during pregnancy are not well reported.
Case Report (n=1)
LDL apheresis may support management of pregnant FH; leaves open need for randomized confirmation before practice change.
Women with familial hypercholesterolemia (FH) should be treated effectively during pregnancy, as elevated low-density lipoprotein cholesterol (LDL-C) levels may result in life-threatening consequences. Hydroxymethylglutaryl-coenzyme A reductase inhibitors are contraindicated during pregnancy, therefore LDL apheresis should be considered in the management of such pregnant cases. There are five different methods of selective LDL apheresis: heparin-induced extracorporeal LDL precipitation, double filtration plasmapheresis, direct adsorption of lipoproteins, dextran sulfate adsorption, and LDL immunoadsorption. The cascade filtration system is another modern and effective method for the extracorporeal elimination of LDL-C, although it is not as selective as the methods mentioned above. Herein, we present the case of a pregnant woman with heterozygous FH and extremely elevated LDL-C levels who has been successfully treated with the cascade filtration system until delivery. As far as we can ascertain, LDL apheresis with the cascade filtration system during pregnancy has not yet been reported in the literature.
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Ertörer et al. (2008) conducted a case report in Heterozygous familial hypercholesterolemia in pregnancy (n=1). Cascade filtration system (LDL apheresis) was evaluated. LDL apheresis using the cascade filtration system was successfully and safely used to treat a pregnant woman with heterozygous familial hypercholesterolemia until delivery.
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