Document Detail


Autopsy case of Dubin-Johnson syndrome with pneumonia and abetalipoproteinemia-like lipid profile.
MedLine Citation:
PMID:  16835471     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report the autopsy of a 79-year-old Japanese woman with Dubin-Johnson syndrome accompanied by pneumonia, an abetalipoproteinemia-like lipid profile and acanthocytosis. On admission, physical examination of the patient revealed malnutrition. Blood tests revealed marked inflammatory changes and mild liver dysfunction. Chest X-ray indicated bilateral pneumonia. Total cholesterol, low-density lipoprotein (LDL) cholesterol and triglyceride levels were 89 mg/dL, 5 mg/dL and 6 mg/dL, respectively. Peripheral blood smears revealed numerous acanthocytes. Despite the administration of antibiotics and nutritional support, the patient died. Autopsy revealed a black liver, atrophy of fat tissue on the mesentery, and pneumonia with bilateral pleural effusion. We believe that the abetalipoproteinemia-like lipid profiles in this case were caused by malnutrition and the inflammatory changes rather than the direct effects of Dubin-Johnson syndrome. We base this conclusion on the following three findings: 1) the patient's lipid profile before hospitalization was in the normal range, 2) her serum LDL cholesterol and triglyceride levels gradually increased after nutritional support began, and 3) blood tests revealed marked inflammatory changes (C-reactive protein 9.0 mg/dL; interleukin-6 16.4 pg/mL). This case provides important information that enhances our understanding of lipid metabolism under conditions of malnutrition and inflammation.
Authors:
Mitsunobu Kaneko; Mitsuo Ohni; Youichi Sugiyama; Shinjirou Mizukawa; Kenji Toba; Atsuhiko Sakamoto; Yoshiya Hata
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of atherosclerosis and thrombosis     Volume:  13     ISSN:  1340-3478     ISO Abbreviation:  J. Atheroscler. Thromb.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-07-12     Completed Date:  2006-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9506298     Medline TA:  J Atheroscler Thromb     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  158-61     Citation Subset:  IM    
Affiliation:
Department of Gerontology, Kyorin University School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Abetalipoproteinemia / blood
Acanthocytes / pathology
Aged
Autopsy
Female
Humans
Inflammation / blood,  metabolism
Jaundice, Chronic Idiopathic / complications,  diagnosis*
Lipid Metabolism
Lipids / blood*
Liver Diseases / blood
Malnutrition / blood,  metabolism
Pneumonia / complications*,  pathology
Chemical
Reg. No./Substance:
0/Lipids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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