Journal of the American Academy of Dermatology
Type III hyperlipoproteinemia with xanthomas and multiple myeloma
Section snippets
Case report
A 72-year-old Caucasian man with a history of unclassified hypercholesterolemia and hypertriglyceridemia, which had been well controlled on simvastatin (20 mg/d), subsequently developed a refractory dyslipidemia. Baseline total cholesterol and triglyceride levels during the past 3 years had been in the range of 155 to 209 mg/dL and 164 to 223 mg/dL, respectively. Total cholesterol levels increased ranging from 394 to 499 mg/dL and triglyceride levels increased ranging from 569 to 893 mg/dL
Discussion
There are several unusual features to this case. First, myelomas can be associated with planar xanthomas, but usually in the setting of normal lipids.2, 3, 4, 5, 6, 7 Although the patient was given the diagnosis of paraproteinemia, he also had evidence of both tuberous and palmar crease xanthomas, pathogonomic of type III hyperlipoproteinemia. Second, type III hyperlipoproteinemias are only rarely associated with myeloma.8, 9, 10, 11, 12, 13, 14, 15, 16 Third, type III hyperlipoproteinemias are
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