High chylomicron remnant causes: Difference between revisions

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Revision as of 03:34, 13 November 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2]

Overview

Once triglyceride stores are distributed, the chylomicron returns APOC2 to the HDL (but keeps APOE), and, thus, becomes a chylomicron remnant. APOB48 and APOE are important to identify the chylomicron remnant in the liver for endocytosis and breakdown. The high chylomicron remnants could either be due to conditions that affect liver metabolism or genetic conditions as in type I and type V hyperlipoproteinemia or secondary to conditions such as chronic renal failure, hypothyroidism, and diabetes mellitus.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Acute renal failure

Common Causes

Causes by Organ System

Cardiovascular	No underlying causes
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Antiretroviral therapy, atypical antipsychotics, glucocorticoids, heparin, isotretinoin, oral contraceptives, tamoxifen, thiazide diuretics
Ear Nose Throat	No underlying causes
Endocrine	Diabetes mellitus, hypothyroidism
Environmental	No underlying causes
Gastroenterologic	Acute pancreatitis, alcoholic liver disease, cirrhosis, hepatitis, hereditary hemochromatosis, non-alcoholic steatohepatitis (NASH), Wilson's disease
Genetic	Familial hypertriglyceridemia, fructose-1-phosphate aldolase deficiency, galactosemia, glycogen storage disease type I, glycogen storage disease type IV, lipoprotein lipase deficiency, mixed hyperlipoproteinemia, type 1C hyperlipoproteinemia, tyrosinaemia type 1
Hematologic	No underlying causes
Iatrogenic	Dialysis
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	Familial hypertriglyceridemia, glycogen storage disease type I, glycogen storage disease type IV, high carbohydrate diet, high saturated fat diet, isolated low HDL, lipoprotein lipase deficiency
Obstetric/Gynecologic	Pregnancy
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	Acute renal failure, chronic renal failure, nephrotic syndrome
Rheumatology/Immunology/Allergy	Autoimmune hyperchylomicronemia ^[1]
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	Alcoholism

Causes by Alphabetical Order

References

↑ ^1.0 ^1.1 Yoshimura, T.; Ito, M.; Sakoda, Y.; Kobori, S.; Okamura, H. (1998). "Rare case of autoimmune hyperchylomicronemia during pregnancy". Eur J Obstet Gynecol Reprod Biol. 76 (1): 49–51. PMID 9481547. Unknown parameter |month= ignored (help)
↑ Weintraub M, Burstein A, Rassin T, Liron M, Ringel Y, Cabili S; et al. (1992). "Severe defect in clearing postprandial chylomicron remnants in dialysis patients". Kidney Int. 42 (5): 1247–52. PMID 1453610.
↑ Ito M, Takamatsu J, Matsuo T, Kameoka K, Kubota S, Fukata S; et al. (2003). "Serum concentrations of remnant-like particles in hypothyroid patients before and after thyroxine replacement". Clin Endocrinol (Oxf). 58 (5): 621–6. PMID 12699445.
↑ Benjó AM, Maranhão RC, Coimbra SR, Andrade AC, Favarato D, Molina MS; et al. (2006). "Accumulation of chylomicron remnants and impaired vascular reactivity occur in subjects with isolated low HDL cholesterol: effects of niacin treatment". Atherosclerosis. 187 (1): 116–22. doi:10.1016/j.atherosclerosis.2005.08.025. PMID 16458316.
↑ Brasaemle DL, Cornely-Moss K, Bensadoun A (1993). "Hepatic lipase treatment of chylomicron remnants increases exposure of apolipoprotein E." J Lipid Res. 34 (3): 455–65. PMID 8468529.

[Yoshimura-1998-1] 1.0 ^1.1 Yoshimura, T.; Ito, M.; Sakoda, Y.; Kobori, S.; Okamura, H. (1998). "Rare case of autoimmune hyperchylomicronemia during pregnancy". Eur J Obstet Gynecol Reprod Biol. 76 (1): 49–51. PMID 9481547. Unknown parameter |month= ignored (help)

[pmid1453610-2] Weintraub M, Burstein A, Rassin T, Liron M, Ringel Y, Cabili S; et al. (1992). "Severe defect in clearing postprandial chylomicron remnants in dialysis patients". Kidney Int. 42 (5): 1247–52. PMID 1453610.

[pmid12699445-3] Ito M, Takamatsu J, Matsuo T, Kameoka K, Kubota S, Fukata S; et al. (2003). "Serum concentrations of remnant-like particles in hypothyroid patients before and after thyroxine replacement". Clin Endocrinol (Oxf). 58 (5): 621–6. PMID 12699445.

[pmid16458316-4] Benjó AM, Maranhão RC, Coimbra SR, Andrade AC, Favarato D, Molina MS; et al. (2006). "Accumulation of chylomicron remnants and impaired vascular reactivity occur in subjects with isolated low HDL cholesterol: effects of niacin treatment". Atherosclerosis. 187 (1): 116–22. doi:10.1016/j.atherosclerosis.2005.08.025. PMID 16458316.

[pmid8468529-5] Brasaemle DL, Cornely-Moss K, Bensadoun A (1993). "Hepatic lipase treatment of chylomicron remnants increases exposure of apolipoprotein E." J Lipid Res. 34 (3): 455–65. PMID 8468529.

[1]

[2]

[3]

[4]

[5]

@@ Line 4: / Line 4: @@
 ==Overview==
-The high chylomicron remnants could either be due to [[genetic]] conditions as in [[Hyperlipoproteinemia|type I and type V hyperlipoproteinemia]] or secondary to conditions such as [[chronic renal failure]], [[hypothyroidism]], and [[diabetes mellitus]].  Secondary causes are more frequent than primary genetic etiologies.
+Once [[triglyceride]] stores are distributed, the [[chylomicron]] returns APOC2 to the [[HDL]] (but keeps APOE), and, thus, becomes a chylomicron remnant.  APOB48 and APOE are important to identify the chylomicron remnant in the liver for endocytosis and breakdown.  The high chylomicron remnants could either be due to conditions that affect liver metabolism or [[genetic]] conditions as in [[Hyperlipoproteinemia|type I and type V hyperlipoproteinemia]] or secondary to conditions such as [[chronic renal failure]], [[hypothyroidism]], and [[diabetes mellitus]].
 ==Causes==
 ===Life Threatening Causes===
 Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
+*[[Acute renal failure]]
-Hyperchylomicronemia does not have life-threatening causes.
 ===Common Causes===
@@ Line 40: / Line 38: @@
 |-bgcolor="LightSteelBlue"
 | '''Drug Side Effect'''
-|bgcolor="Beige"| [[Heparin]], [[Combined oral contraceptive pill|oral contraceptives]], [[Thiazide|thiazide diuretics]]
+|bgcolor="Beige"| [[Antiretroviral therapy]], [[atypical antipsychotics]], [[glucocorticoids]], [[heparin]], [[isotretinoin]], [[Combined oral contraceptive pill|oral contraceptives]], [[tamoxifen]], [[Thiazide|thiazide diuretics]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 56: / Line 54: @@
 |-bgcolor="LightSteelBlue"
 | '''Gastroenterologic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Acute pancreatitis]], [[alcoholic liver disease]], [[cirrhosis]], [[hepatitis]], [[hereditary hemochromatosis]], [[Non-alcoholic fatty liver disease|non-alcoholic steatohepatitis (NASH)]], [[Wilson's disease]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Genetic'''
-|bgcolor="Beige"| [[Glycogen storage disease type I]], [[lipoprotein lipase deficiency]], [[familial hyperchylomicronemia|type 1C hyperlipoproteinemia]], [[mixed hyperlipoproteinemia ]]
+|bgcolor="Beige"| [[Familial hypertriglyceridemia]], [[fructose-1-phosphate aldolase deficiency]], [[galactosemia]], [[glycogen storage disease type I]], [[glycogen storage disease type IV]], [[lipoprotein lipase deficiency]], [[mixed hyperlipoproteinemia]], [[familial hyperchylomicronemia|type 1C hyperlipoproteinemia]], [[tyrosinaemia type 1]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 68: / Line 66: @@
 |-bgcolor="LightSteelBlue"
 | '''Iatrogenic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Dialysis]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 84: / Line 82: @@
 |-bgcolor="LightSteelBlue"
 | '''Nutritional/Metabolic'''
-|bgcolor="Beige"| [[Familial hypertriglyceridemia]], [[glycogen storage disease type I]], [[lipoprotein lipase deficiency]]
+|bgcolor="Beige"| [[Familial hypertriglyceridemia]], [[glycogen storage disease type I]], [[glycogen storage disease type IV]], [[carbohydrate|high carbohydrate diet]], [[fat|high saturated fat diet]], [[HDL|isolated low HDL]], [[lipoprotein lipase deficiency]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 100: / Line 98: @@
 |-bgcolor="LightSteelBlue"
 | '''Overdose/Toxicity'''
-|bgcolor="Beige"| [[Alcoholism|Alcohol]]
+|bgcolor="Beige"| No underlying causes
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 112: / Line 110: @@
 |-bgcolor="LightSteelBlue"
 | '''Renal/Electrolyte'''
-|bgcolor="Beige"| [[Chronic renal failure]]
+|bgcolor="Beige"| [[Acute renal failure]], [[chronic renal failure]], [[nephrotic syndrome]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Rheumatology/Immunology/Allergy'''
-|bgcolor="Beige"| [[Autoimmune hyperchylomicronemia ]]<ref name="Yoshimura-1998">{{Cite journal | last1 = Yoshimura | first1 = T. | last2 = Ito | first2 = M. | last3 = Sakoda | first3 = Y. | last4 = Kobori | first4 = S. | last5 = Okamura | first5 = H. | title = Rare case of autoimmune hyperchylomicronemia during pregnancy. | journal = Eur J Obstet Gynecol Reprod Biol | volume = 76 | issue = 1 | pages = 49-51 | month = Jan | year = 1998 | doi = | PMID = 9481547 }}</ref>
+|bgcolor="Beige"| [[hyperchylomicronemia|Autoimmune hyperchylomicronemia ]]<ref name="Yoshimura-1998">{{Cite journal | last1 = Yoshimura | first1 = T. | last2 = Ito | first2 = M. | last3 = Sakoda | first3 = Y. | last4 = Kobori | first4 = S. | last5 = Okamura | first5 = H. | title = Rare case of autoimmune hyperchylomicronemia during pregnancy. | journal = Eur J Obstet Gynecol Reprod Biol | volume = 76 | issue = 1 | pages = 49-51 | month = Jan | year = 1998 | doi = | PMID = 9481547 }}</ref>
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 132: / Line 130: @@
 |-bgcolor="LightSteelBlue"
 | '''Miscellaneous'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Alcoholism]]
 |-
 |}
@@ Line 139: / Line 137: @@
 {{col-begin|width=80%}}
 {{col-break|width=33%}}
+*[[Acute pancreatitis]]
+*[[Acute renal failure]]
+*[[Alcoholic liver disease]]
 *[[Alcoholism]]
-*[[Autoimmune hyperchylomicronemia]]<ref name="Yoshimura-1998">{{Cite journal | last1 = Yoshimura | first1 = T. | last2 = Ito | first2 = M. | last3 = Sakoda | first3 = Y. | last4 = Kobori | first4 = S. | last5 = Okamura | first5 = H. | title = Rare case of autoimmune hyperchylomicronemia during pregnancy. | journal = Eur J Obstet Gynecol Reprod Biol | volume = 76 | issue = 1 | pages = 49-51 | month = Jan | year = 1998 | doi = | PMID = 9481547 }}</ref>
+*[[Antiretroviral therapy]]
+*[[Atypical antipsychotics]]
+*[[hyperchylomicronemia|Autoimmune hyperchylomicronemia]]<ref name="Yoshimura-1998">{{Cite journal | last1 = Yoshimura | first1 = T. | last2 = Ito | first2 = M. | last3 = Sakoda | first3 = Y. | last4 = Kobori | first4 = S. | last5 = Okamura | first5 = H. | title = Rare case of autoimmune hyperchylomicronemia during pregnancy. | journal = Eur J Obstet Gynecol Reprod Biol | volume = 76 | issue = 1 | pages = 49-51 | month = Jan | year = 1998 | doi = | PMID = 9481547 }}</ref>
 *[[Chronic renal failure]]
+*[[Cirrhosis]]
 *[[Diabetes mellitus]]
+*[[Dialysis]]<ref name="pmid1453610">{{cite journal| author=Weintraub M, Burstein A, Rassin T, Liron M, Ringel Y, Cabili S et al.| title=Severe defect in clearing postprandial chylomicron remnants in dialysis patients. | journal=Kidney Int | year= 1992 | volume= 42 | issue= 5 | pages= 1247-52 | pmid=1453610 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1453610 }} </ref>
 *[[Familial hyperchylomicronemia|Type 1B hyperlipoproteinemia]]
 *[[Familial hypertriglyceridemia]]
+{{col-break|width=33%}}
+*[[Fructose-1-phosphate aldolase deficiency]]
+*[[Galactosemia]]
 *[[Glycogen storage disease type I]]
+*[[Glycogen storage disease type IV]]
 *[[Heparin]]
-*[[Hypothyroidism]]
+*[[Hepatitis]]
-*[[Familial hyperchylomicronemia|Lipoprotein lipase deficiency]]
+*[[Hereditary hemochromatosis]]
+*[[carbohydrate|High carbohydrate diet]]
+*[[fat|High saturated fat diet]]
+*[[Hypothyroidism]]<ref name="pmid12699445">{{cite journal| author=Ito M, Takamatsu J, Matsuo T, Kameoka K, Kubota S, Fukata S et al.| title=Serum concentrations of remnant-like particles in hypothyroid patients before and after thyroxine replacement. | journal=Clin Endocrinol (Oxf) | year= 2003 | volume= 58 | issue= 5 | pages= 621-6 | pmid=12699445 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12699445 }} </ref>
+*[[HDL|Isolated low HDL]]<ref name="pmid16458316">{{cite journal| author=Benjó AM, Maranhão RC, Coimbra SR, Andrade AC, Favarato D, Molina MS et al.| title=Accumulation of chylomicron remnants and impaired vascular reactivity occur in subjects with isolated low HDL cholesterol: effects of niacin treatment. | journal=Atherosclerosis | year= 2006 | volume= 187 | issue= 1 | pages= 116-22 | pmid=16458316 | doi=10.1016/j.atherosclerosis.2005.08.025 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16458316 }} </ref>
+*[[Familial hyperchylomicronemia|Lipoprotein lipase deficiency]]<ref name="pmid8468529">{{cite journal| author=Brasaemle DL, Cornely-Moss K, Bensadoun A| title=Hepatic lipase treatment of chylomicron remnants increases exposure of apolipoprotein E. | journal=J Lipid Res | year= 1993 | volume= 34 | issue= 3 | pages= 455-65 | pmid=8468529 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8468529 }} </ref>
+{{col-break|width=33%}}
+*[[Glucocorticoids]]
+*[[Isotretinoin]]
+*[[Mixed hyperlipoproteinemia ]]
+*[[Non-alcoholic fatty liver disease|Non-alcoholic steatohepatitis (NASH)]]
 *[[Combined oral contraceptive pill|Oral contraceptives]]
 *[[Pregnancy]]
+*[[Tamoxifen]] [[glucocorticoids]] [[isotretinoin]] [[Antiretroviral therapy]] [[atypical antipsychotics]]
 *[[Thiazide|Thiazide diuretics]]
 *[[Familial hyperchylomicronemia|Type 1C hyperlipoproteinemia]]
-*[[Mixed hyperlipoproteinemia ]]
+*[[Tyrosinaemia type 1]]
+*[[Wilson's disease]]
 {{col-end}}

v t e Lipopedia
Basic Science	Cholesterol • Triglyceride Lipoprotein metabolism and transport Lipoprotein: Chylomicron • Chylomicron remnant • HDL • IDL • LDL • Lipoprotein(a) • VLDL • Lipoprotein-X Apolipoprotein: APOA (1, 2, 4, 5) • APOB ( Apolipoprotein B-48, Apolipoprotein B-100) • APOC (1, 2, 3, 4) • APOD • APOE • APOH • APOJ • APOL • APOM • Apo(a) Lipoprotein receptor: LDL receptor • Soluble low density lipoprotein receptor-related protein (sLRP) • Apolipoprotein E Receptor 2 • Scavenger receptor • Scavenger receptor A • Scavenger receptor B • VLDL receptor Lipoprotein enzymes: Lipoprotein lipase • Lipoprotein-associated phospholipase A2 (Lp-PLA2) • Cholesterylester transfer protein ( Acetyl-CoA C-acyltransferase, Lecithin-cholesterol acyltransferase) • Microsomal triglyceride transfer protein • ABCA1 Genes: Low density lipoprotein receptor gene family • Microsomal triglyceride transfer protein • ABCA1
Lipoprotein Disorders	Lipoprotein disorders Primary lipoprotein disorders: Familial hyperchylomicronemia (Type I) • Familial hypercholesterolemia (Type IIA) • Familial combined hyperlipidemia (Type IIB) • Dysbetalipoproteinemia (Type III) • Primary hypertriglyceridemia (Type IV) • Mixed hyperlipoproteinemia (Type V) Secondary lipoprotein disorders
Abnormal Laboratory Lipid Profile	Low chylomicron • Low chylomicron remnant • Low HDL • Low IDL • Low LDL • Low lipoprotein(a) • Low VLDL High chylomicron • High chylomicron remnant • High HDL • High IDL • High LDL • High Lipoprotein(a) • High VLDL