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December 1972

Acquired Type 3 Hyperlipoproteinemia: Report of Three Cases Associated With Systemic Lupus Erythematosus and Diabetic Ketoacidosis

Author Affiliations

Palo Alto, Calif

From the Department of Medicine, Palo Alto Veterans Administration Hospital, and Stanford University School of Medicine, Palo Alto, Calif. Mr. Kolterman is a Stanford University medical student.

Arch Intern Med. 1972;130(6):817-821. doi:10.1001/archinte.1972.03650060013003

Acquired type 3 hyperlipoproteinemia was observed in two patients with systemic lupus erythematosus. In one, the abnormality disappeared after treatment with adrenocortical steroids for seven months. Transient type 3 hyperlipoproteinemia was also observed in a patient with diabetic ketoacidosis. None of the patients had palmar xanthomata. Type 3 hyperlipoproteinemia was not found among ten family members of these three patients, supporting the concept that these patients represent cases of acquired, rather than inherited, type 3 hyperlipoproteinemia. Postheparin lipase activity (PHLA) was decreased in the two patients with systemic lupus erythematosus. In one, PHLA became normal after adrenocortical steroid treatment concomitantly with the disappearance of the type 3 hyperlipoproteinemia. This finding raises the possibility that PHLA deficiency may have played a role in the development of the type 3 hyperlipoproteinemic pattern.