A double Case study. Mother, son, and their familial dyslipidemia: a different response to statin treatment.

• Cesare Achilli,  
• Clara Gasparri,*  
• Alessia Moroni,  
• Mariangela Rondanelli

Abstract

Hypercholesterolemia is one of the main modifiable risk factors for the onset of myocardial infarction, and one of the key factors for the onset of hypercholesterolemia is the genetic predisposition. The therapy of choice to restore cholesterol to normal values is represented by statins, a class of cholesterol biosynthesis inhibitors. Some patients are intolerant to this class of molecules, triggering serious side effects, or show a resistance (often based also on genetic factors) to their action. In this report we present the case of two related patients (mother and son) with familial hypercholesterolemia of medium severity. The first patient presents total resistance to all the statins tested (simvastatin, monacolin K, rosuvastatin) at any dosage and the resolution is found by combining the rosuvastatin therapy with ezetimibe, an inhibitor of intestinal cholesterol absorption. For the second patient, in therapy with a supplement of monacolin K, the feedback is positive even at low doses.

Keywords

cholesterol, LDL, familiar hypercholesterolemia, statins, monacolin K, fermented red rice, rosuvastatin,ezetimibe