Lipoprotein X in the Setting of COVID-19–Induced Cholangiopathy: An Unforeseen Event

Elevated low-density lipoprotein cholesterol (LDL-C) is a well-known culprit for atherosclerosis; however, elevated lipoprotein X (LpX), an abnormal lipoprotein as dense as LDL-C, may confound differentiation between true hyperlipidemia and cholestasis-induced hyperlipidemia. We present the case of...

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Main Authors: Hardik Patel, Felix Berglund, Christina C. Lindenmeyer, Nicholas Ruthmann
Format: Article
Language:English
Published: American College of Physicians 2024-01-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2023.0813
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author Hardik Patel
Felix Berglund
Christina C. Lindenmeyer
Nicholas Ruthmann
author_facet Hardik Patel
Felix Berglund
Christina C. Lindenmeyer
Nicholas Ruthmann
author_sort Hardik Patel
collection DOAJ
description Elevated low-density lipoprotein cholesterol (LDL-C) is a well-known culprit for atherosclerosis; however, elevated lipoprotein X (LpX), an abnormal lipoprotein as dense as LDL-C, may confound differentiation between true hyperlipidemia and cholestasis-induced hyperlipidemia. We present the case of a 34-year-old man diagnosed with COVID-19–induced cholangiopathy with LpX. Despite treatment with evolocumab and plasmapheresis, the patient had persistent cholestasis and ultimately received a liver transplant, resulting in the resolution of hyperlipidemia. This case highlights the potential association between LpX and COVID-19–induced cholangiopathy, emphasizing the need for further research to better understand the underlying mechanisms and treatment options for this complex disease.
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-bc2ffba0aea547c8b4371dd79128e8012025-08-20T02:27:20ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-01-013110.7326/aimcc.2023.0813Lipoprotein X in the Setting of COVID-19–Induced Cholangiopathy: An Unforeseen EventHardik Patel0Felix Berglund1Christina C. Lindenmeyer2Nicholas Ruthmann31Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio2Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio3Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio2Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OhioElevated low-density lipoprotein cholesterol (LDL-C) is a well-known culprit for atherosclerosis; however, elevated lipoprotein X (LpX), an abnormal lipoprotein as dense as LDL-C, may confound differentiation between true hyperlipidemia and cholestasis-induced hyperlipidemia. We present the case of a 34-year-old man diagnosed with COVID-19–induced cholangiopathy with LpX. Despite treatment with evolocumab and plasmapheresis, the patient had persistent cholestasis and ultimately received a liver transplant, resulting in the resolution of hyperlipidemia. This case highlights the potential association between LpX and COVID-19–induced cholangiopathy, emphasizing the need for further research to better understand the underlying mechanisms and treatment options for this complex disease.https://www.acpjournals.org/doi/10.7326/aimcc.2023.0813
spellingShingle Hardik Patel
Felix Berglund
Christina C. Lindenmeyer
Nicholas Ruthmann
Lipoprotein X in the Setting of COVID-19–Induced Cholangiopathy: An Unforeseen Event
Annals of Internal Medicine: Clinical Cases
title Lipoprotein X in the Setting of COVID-19–Induced Cholangiopathy: An Unforeseen Event
title_full Lipoprotein X in the Setting of COVID-19–Induced Cholangiopathy: An Unforeseen Event
title_fullStr Lipoprotein X in the Setting of COVID-19–Induced Cholangiopathy: An Unforeseen Event
title_full_unstemmed Lipoprotein X in the Setting of COVID-19–Induced Cholangiopathy: An Unforeseen Event
title_short Lipoprotein X in the Setting of COVID-19–Induced Cholangiopathy: An Unforeseen Event
title_sort lipoprotein x in the setting of covid 19 induced cholangiopathy an unforeseen event
url https://www.acpjournals.org/doi/10.7326/aimcc.2023.0813
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AT nicholasruthmann lipoproteinxinthesettingofcovid19inducedcholangiopathyanunforeseenevent