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Case ReportOpen Access

Two Long-Term Follow-Up Cases Preventing Atherosclerosis by Hormone Replacement Therapy-CETP Deficiency and Tangier Disease

Volume 9 - Issue 5

Kiyomitsu Miyachi*1,4, Minoru Ihara1, Toshitsugu Ishikawa2, Belinda Sasse1,3, Toshiko Igarashi4, Takao Koyama5, Keijiro Saku6, Katsuhiko Mikoshiba7 and Akihiro Inazu8

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    • 1Keigu Clinic, Japan
    • 2Tamachi Tokuei-building Clinic, Japan
    • 3Monash Health Rheumatology, Australia
    • 4Health Sciences Research Institute, Japan
    • 5Koyama Takao Clinic, Japan
    • 6Fukuoka University Hospital, Fukuoka
    • 7Riken (Laboratory for Developmental Neurobiology Brain Science Institute) Wako, Japan
    • 8Kanazawa University, Department of Clinical Laboratory Science, Faculty of Health Sciences Institute of Medical, Japan

    *Corresponding author: Kiyomitsu Miyachi, Keigu Clinic, Yokohama, 230-0023, Japan

Received:September 28, 2018;   Published: October 10, 2018

DOI: 10.26717/BJSTR.2018.09.001868

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Abstract

We reported two cases being treated with HRT for the past 7~11 years presenting no progression in atherosclerosis. The first case was diagnosed of having CETP deficiency (homozygosity type) and fibromyalgia at the age of 52. The HDL-cholesterol level was around 200 mg/ ml, CETP DNA point mutation found in intron 14 variant type (A/A) and exon 15 wild type (A/A) were obtained. HRT relieved myalgia and joint pain as well as JFIQ baseline score 91was reduced to 36, following a 3 months therapy. The second case was diagnosed as a Tangier disease, presenting 1~2 mg/dL of HDL cholesterol and a very low level of LDL-C at the age of 52. Her ANA with anti-centromere antibody 80 at the first visit rose to 640. Depression and shortness of breath disappeared while HRT was continued, However, HRT was discontinued for four years, which made osteoporosis and Altzheimer’s disease more progressive. The patient remained in good health as a result of the E3 2 mg/day and αtocopherol 600 mg/day that she has been receiving since 2015. In both cases, HRT served as a good therapy for mid aged women in the prevention of atherosclerosis.

Keywords : Tangier disease (TD); Cholesterol ester transfer protein (CETP); High density lipoprotein cholesterol (HDL-C); Estrogen progesterone replacement therapy (EPRT); Estradiol (E2); Estriol (E3); Atherosclerosis

Abbreviations : TD: Tangier Disease; CETP: Cholesterol Ester Transfer Protein; HDL-C: High Density Lipoprotein Cholesterol; EPRT: Estrogen Progesterone Replacement Therapy; E2: Estradiol; E3: Estriol; HRT: Hormone Replacement Therapy; CEE: Conjugated Equine Estrogen; FSH: Follicle Stimulating Hormone; CAVI: Cardio Ankle Vascular Index; ABI: Ankle Brachial Pressure Index; FMD: Flow Mediated Dilatation; PCI; Percutaneous Coronary Intervention; IMT; Intima Media Thickness; CT: Computed Tomography; ERT: Estrogen Replacement Therapy; ANA: Anti-Nuclear Antibody; SRL: Special Reference Laboratory

Abstract | Introduction| Methods| Results| Discussion| Acknowledgement| Biographical note| References|