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

Kiyomitsu Miyachi; Minoru Ihara; Toshitsugu Ishikawa; Belinda Sasse; Toshiko Igarashi; Takao Koyama; Keijiro Saku; Katsuhiko Mikoshiba; Akihiro Inazu

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 Sasse^1,3, Toshiko Igarashi⁴, Takao Koyama⁵, Keijiro Saku⁶, Katsuhiko Mikoshiba⁷ and Akihiro Inazu⁸**

Author Information Open or Close
- 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

Full Text PDF

To view the Full Article Peer-reviewed Article PDF

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