Hyperlipidemic myeloma, a rare form of acquired dysbetalipoproteinemia, in an HIV seropositive African female.
Dysbetalipoproteinemia (DBL) is an uncommon condition characterized by a mixed hyperlipidemia due to accumulation of remnant lipoproteins and is highly atherogenic. Typically, DBL is an autosomal recessive condition requiring an additional metabolic stress with reduced apolipoprotein E (apoE) function. However, DBL is also described in patients with multiple myeloma without the characteristic apoE2/E2 mutation seen in familial DBL. Although the underlying pathogenesis in these cases is not fully characterized, it is thought to occur due to interference with apoE function by antibodies produced from clonal plasma cells. Such cases are referred to as hyperlipidemic myeloma (HLM) and have rarely been described in the literature. To our knowledge there is no prior description of HLM in HIV positive patients in Africa. We describe a case of HLM in an African woman with underlying HIV infection who presented with phenotypic and biochemical features of DBL that responded poorly to lipid lowering therapy.
['Seedat|Faheem|F|', 'Patel|Moosa|M|', 'Phillip|Vinitha|V|', 'Mohamed|Farzahna|F|', 'Marais|A David|AD|', 'Blackhurst|Dee M|DM|', 'Solomon|Gabriele|G|', 'Currin|Sean|S|', 'Raal|Frederick J|FJ|']
D000349:Africa D053329:Apolipoprotein E2 D001057:Apolipoproteins E D005260:Female D015658:HIV Infections D006801:Humans D006952:Hyperlipoproteinemia Type III D009101:Multiple Myeloma D014280:Triglycerides
Hyperlipidemic myeloma Dysbetalipoproteinemia Multiple myeloma Plasma cell dyscrasia