Pregnancy in homozygous familial hypercholesterolemia—A case series. (5th December 2022)

• Record Type: Journal Article
• Authors: Bláha, Milan; Veletová, Kateřina; Blaha, Vladimír; Lánská, Miriam; Žák, Pavel
• Is Part Of: Therapeutic apheresis and dialysis. Volume 26(2022)Supplement 1
• Page Start: 89
• Page End: 96
• Publication Date: 2022-12-05
• Subjects: atherosclerosis -- cardiovascular disease -- homozygous familial hypercholesterolemia -- LDL‐apheresis -- pregnancy; Hemapheresis -- Periodicals; Dialysis -- Periodicals; Blood Component Removal -- Periodicals; Renal Dialysis -- Periodicals; Hémaphérèse -- Périodiques; Dialyse -- Périodiques; Sang -- Collecte et conservation -- Périodiques; 616
• DOI: 10.1111/1744-9987.13841
• Languages: English
• ISSNs: 1744-9979

Abstract

Abstract: Introduction: Familial hypercholesterolemia (FH) is an autosomal codominant lipid metabolism disorder. It results in lifelong elevation of plasmatic low‐density lipoprotein cholesterol (LDL‐C) levels, followed by premature atherosclerosis. In women, pregnancy and lactation represent an additional risk due to association of physiological changes, pre‐existing dyslipidemia, and limited therapeutic possibilities and experiences. Methods of extracorporeal LDL‐apheresis represent a suitable therapeutic approach. Case series: We present our experience in case reports of six HoFH women and their 13 pregnancies (nine successful, three abortions, and one interruption). One patient experienced a lethal complication of her pregnancy. Of the nine successful pregnancies, two cases were treated by LDL‐apheresis. Conclusion: Pregnancy in HoFH women represents substantial risk; however, patients without signs of decompensated cardiovascular disease can have a good prognosis. LDL‐apheresis plays an important role in the management of pregnancy in HoFH.