Tendon Xanthomas

Dear students,

Sharing with you a case I encountered in the cardiology ward some years ago. It was a case of a young patient in her 20s. She suffered an extensive myocardial infarction few months before I met her in the cardiology ward. She was admitted for coronary angioplasty plus stenting.

She had several siblings who were all myocardial infarction survivors and if I recall correctly, her parents were also cardiovascular patients. She has familial hyperlipidemia. 

I recalled her blood lipid levels were shockingly high and blood samples were very lipemic (oily). She was already on several high dose statins and fibrates. My colleagues in the cardiology team were even discussing plans for a lipid dialysis as they were desperately trying to solve her resistantly high blood lipid levels. The challenge was that the treatment was very limited and only very few centres were offering such treatment options, not to mention the high cost of such treatment as well. 

Below are pictures of tendon xanthomas found on the patient.

For those who have yet to see tendon xanthomas, the above photos depict how one looks like. Good luck.

CCE.