HERITABLE disorders causing profound high-density lipoprotein (HDL) deficiency include Tangier disease1 and familial lecithin-cholesterol acyltransferase (LCAT) dificiency.2 Acquired HDL deficiency of comparable severity is usually associated with obstructive or parenchymal liver disease.3 We describe a patient with fever, transient leukopenia, and evidence of mild hepatic dysfunction who nevertheless exhibited a striking reduction of serum HDL. An LCAT deficiency in association with a viral syndrome appeared to be the most likely origin.
Report of a Case
A 25-year-old woman was in good health until one week before presentation, when she experienced a flulike illness. Three days before admission she noted a severe sore throat and gingival ulcers, fever, weakness, and cervical lymphadenopathy. No other significant history was available except for possible exposure to acrylic paints and amphetaminelike compounds. Physical examination demonstrated aphthous ulcers on her gingivae, pharyngitis with a right tonsillary exudate, and bilateral large, tender, anterior cervical