CPY 521: CHEMICAL PATHOLOGY IV

BY
MRS N. OSAKUE
 Dyslipidaemia
• Dyslipoproteinaemia, also referred to as dyslipidaemia, encompasses a
range of disorders of lipoprotein lipid metabolism that include both
abnormally high and low lipoprotein concentrations, as well as
abnormalities in the composition of these lipoprotein particles.
• Dyslipidaemia can be referred to as an abnormal amount of lipids (e.g.
triglycerides, cholesterol and/or fat phospholipids) in the blood.
• Dyslipidaemia is an important modifiable risk factor for the development of
atherosclerosis and cardiovascular disease.
• The World Health Organization estimates that dyslipidaemia is associated
with more than 50% of global cases of ischemic heart disease, and over 4
million deaths per year.
• About 80% of lipid disorders are related to diet and lifestyle, with the
remainder being familial. 
 Types of hyperlipoptoteinaemia
• There are several types of hyperlipoproteinaemia. The type depends on
the concentration of lipids and which ones are affected.
• Primary or familial hyperlipoproteinaemia: Familial  hyperlipidemias are
classified according to the Fredrickson classification, which is based on the
lipoprotein pattern in electrophoresis or ultracentrifugation.
– There are five types of primary hyperlipoproteinaemia
• Secondary or acquired hyperlipoproteinaemia : Acquired  hyperlipidaemias
(also called secondary dyslipoproteinaemias)
 Causes
• Hyperlipoproteinaemia can be a primary or secondary condition.
• Primary hyperlipoproteinaemia is often genetic. It is the result of a defect
or mutation in lipoproteins. These changes result in problems with the
accumulation of lipids in your body.
• The secondary hyperlipoproteinaemia is the result of other health
conditions that lead to high levels of lipids in your body. These include:
– Diabetes.
– Hypothyroidism .
– Pancreatitis.
– Use of certain medications, such as contraceptives and steroids.
– Certain lifestyle choices.
 Causes
• Hyperlipoproteinaemia can be a primary or secondary condition.
• Primary hyperlipoproteinaemia is often genetic. It is the result of a defect
or mutation in lipoproteins. These changes result in problems with the
accumulation of lipids in your body.
• The secondary hyperlipoproteinaaemia is the result of other health
conditions that lead to high levels of lipids in your body. These include:
• Diabetes.
• Hypothyroidism.
• Pancreatitis.
• Use of certain medications, such as contraceptives and steroids.
• Certain lifestyle choices.
 Symptoms of hyperlipoproteinaemia
• Lipid deposits are the main symptom of hyperlipoproteinaemia. 
• The location of lipid deposits can help determine the type. 
• Some lipid deposits, called xanthomas, are yellow and crunchy. These occur on
the skin.
• Many people with this condition do not experience any symptoms. They can
realize this when they develop a heart condition.
• Other signs and symptoms of hyperlipoproteinaemia include:
– Pancreatitis (type 1).
– Abdominal pain (types 1 and 5).
– Enlarged liver or spleen (type 1).
– Deposits of lipids or xanthomas (type 1).
– Family history of heart disease (types 2 and 4).
– Family history of diabetes (types 4 and 5).
– Heart attack.
 Diagnosis
• Blood test. 
• History taking
• Physical examination
 Hypolipoproteinaemia
• Hypolipoproteinaemia, or hypolipidaemia (British English) is a form
of dyslipidaemia that is defined by abnormally lowered levels of any or
all lipids and/or lipoproteins in the blood.

Causes and symptoms

Low blood fats can be the result of several diseases, or they can be a primary 
genetic disease with other associated abnormalities.
• Malnutrition is a lack of food, including fats, in the diet.
• Malabsorption is the inability of the bowel to absorb food, causing malnutrition.
• Anemia (too few red blood cells) and hyperthyroidism also reduce blood fats.
• Rare genetic conditions called hypobetalipoproteinemia and abetalipoproteinem
ia cause malabsorption.
• Tangier disease, causes only the cholesterol to be low.
• Symptoms are associated more closely with the cause rather than the actual low 
blood fats.
 Diagnosis
• Blood tests often done after an overnight fast.

Treatment
• Supplemental vitamin E helps children with the betalipoprotein deficiencies. 
• There is no known treatment for Tangier disease. 
• Treatment of the causes of the other forms of low blood fats reverses the conditi
on.