Author + information
- Received May 3, 2011
- Revision received May 19, 2011
- Accepted May 31, 2011
- Published online November 29, 2011.
- Chunlai Shao, MD*,
- Weiting Xu, MD*,
- Jianchang Chen, MD, PhD*,
- Liangping Zhao, MD* and
- Pieter R. Stella, MD, PhD†
A 45-year-old man with hyperlipidemia was admitted to the hospital because of iterative retrosternal chest pain for 9 months. He had been diagnosed with hyperlipidemia and acute pancreatitis at 28 years of age. Physical examination revealed the presence of multiple tuberous and tendinous xanthomas at the knuckles of the middle finger (A), right elbow (B), Achilles tendons (C), and glutea (D). Biopsies demonstrated lipid-laden histiocytes and Touton giant cells mixed with fibrotic collagen (E). The serum lipid profile was abnormal: total cholesterol was 245 mg/dl; low-density lipoprotein was 197 mg/dl; high-density lipoprotein was 33 mg/dl; triglycerides was 219 mg/dl. Coronary angiography showed a 95% stenosis in the mid right coronary artery (F) and a significant stenosis at the left main coronary artery involving the ostial left anterior descending coronary artery and proximal left circumflex coronary artery (G). The patient underwent successful coronary artery bypass grafting. Clinical studies have suggested that a positive correlation exists between tendon xanthoma regression and improvement in atherosclerotic disease (1).
- Received May 3, 2011.
- Revision received May 19, 2011.
- Accepted May 31, 2011.
- American College of Cardiology Foundation