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William R. Hazzard, MD; Edwin L. Bierman, MD

Arch Intern Med. 1972;130(6):822-828.

Abstract
A man with peripheral atherosclerosis manifested concurrent postsurgical hypothyroidism and braod-β disease (type 3 hyperlipoproteinemia). In the presence of both, low-density lipoprotein levels remained normal, but very low-density lipoprotein (VLDL) levels were markedly increased, β-migrating, and rich in cholesterol. During replacement therapy with levothyroxine, cholesterol and triglyceride levels were initially reduced to normal, and the diagnosis of broad-β disease became uncertain. Its persistence was suggested by the relative prominence of Sf12-100 lipoproteins, the cholesterol-rich composition of VLDL subfractions and of chylomicrons persisting late after an orally administered fat load, the preponderance of slower-migrating lipoproteins in the Sf20-60 subfraction. With time, moderate hyperlipoproteinemia returned, and broad-β disease was again clearly evident. Thus, secondary factors may interact with the primary metabolic defect to influence the chemical, and possibly clinical, expression of broad-β disease.

Author Affiliations
Seattle

From the Department of Medicine, University of Washington School of Medicine, and Veterans Administration Hospital, Seattle.

Footnotes
Received for publication April 5, 1972; accepted April 28.

Reprint requests to 4435 Beacon Ave S, Seattle 98108 (Dr. Hazzard).

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