Double-Filtration Plasmapheresis for Hypertriglyceridemia

Renato Candrina, MD; Ottavio Di Stefano, MD; Sara Spandrio, MD; Gianni Giustina, MD
JAMA. 1990;263(1):35. doi:10.1001/jama.1990.03440010033015.
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To the Editor.—  Recent reports describe the usefulness of plasmapheresis in the acute management of severe type V hyperlipoproteinemia.1,2 This procedure is usually performed using a continuous-flow centrifugation device that separates plasma from blood cells, and discarded plasma is substituted with either fresh-frozen or stored plasma, albumin, or other plasma derivatives. We also have found useful in the management of severe hypertriglyceridemia double-filtration plasmapheresis, a technique that has found application in Japan3 for selected cases of familial hypercholesterolemia.4

Report of a Case.—  A 61-year-old physician with long-standing non—insulin-dependent diabetes mellitus (poorly controlled by diet and the use of oral agents), obesity (body mass index, 29.5 kg/m2), and mixed hyperlipidemia was admitted for severe dyspnea and chest pain. A complex metabolic derangement was documented, with fasting hyperglycemia (glucose level, 13.9 mmol/L), glycosuria, an elevated glycosylated hemoglobin level (9.6%; normal range, 3% to 6%), and fasting chylomicronemia


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