There is another choice to consider. Primum non nocere.
Looking for an FH mutation could be useful, but with no family history of vascular disease, even finding a mutation might not give you an accurate picture of his personal CV risk to weigh up against the risk of intestinal bypass.
What's his BMI, Ewan?
Clodagh
------------------------------------------------------------------------------------
CM Loughrey MD MRCP FRCPath
Consultant Chemical Pathologist,
Belfast City Hospital, Belfast Health and Social Care Trust
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mohammad Al-Jubouri
Sent: 13 June 2011 16:17
To: [log in to unmask]
Subject: Re: To Lipidologists
Hi Ewan,
Is he heterozygous FH?
You have no other choice left, Questran or surgery (partial ileal bypass).
Regards
Mohammad
Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath
Consultant Chemical Pathologist
________________________________
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Bell Ewan (NHS DUMFRIES & GALLOWAY)
Sent: 13 June 2011 15:50
To: [log in to unmask]
Subject: To Lipidologists
Hi
I have a 53 year old male with a cholesterol of 10, normal trigs and HDL. He has hypertension but no vascular history. He has no family history. LFTs, UEs, TFTs all normal with negative ACR.
He has been on lowest dose simvastatin, pravastatin, atorvastatin, rosuvastatin, which he can't tolerate due to myositis (indeed on rosuvastatin his CK went up to 1,500). Fibrates and ezetimibe weren't tolerated. Tredaptive was tolerated but didn't work (cholesterol still 10).
What do I do next?
Thanks for your help,
Ewan
Dr Ewan Bell
Clinical Director - Diagnostics
NHS Dumfries and Galloway
UK
********************************************************************************************************************
This message may contain confidential information. If you are not the intended recipient please inform the
sender that you have received the message in error before deleting it.
Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents:
to do so is strictly prohibited and may be unlawful.
Thank you for your co-operation.
NHSmail is the secure email and directory service available for all NHS staff in England and Scotland
NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and GSi recipients
NHSmail provides an email address for your career in the NHS and can be accessed anywhere
For more information and to find out how you can switch, visit www.connectingforhealth.nhs.uk/nhsmail
********************************************************************************************************************
------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk <http://www.acb.org.uk/> Green Laboratories Work http://www.laboratorymedicine.nhs.uk <http://www.laboratorymedicine.nhs.uk/> List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html <http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html> List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
---------------------------------------------------------------------------------------------------------------------
Virus Scanned and Verified by St Helens and Knowsley Health Informatics
---------------------------------------------------------------------------------------------------------------------
DISCLAIMER: This e-mail may contain confidential and/or proprietary information some or all
of which may be legally privileged. It is for the intended recipient only. If any addressing or
transmission error has misdirected this e-mail, please notify the author by replying to this e-
mail and destroy any copies. If you are not the intended recipient you must not use, disclose,
distribute, copy, print, or rely on this e-mail.
The information contained in this email may be subject to public disclosure under the
Freedom of Information Act 2000. Unless the information is legally exempt from disclosure,
the confidentiality of this email AND YOUR REPLY cannot be guaranteed.
------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk <http://www.acb.org.uk> Green Laboratories Work http://www.laboratorymedicine.nhs.uk <http://www.laboratorymedicine.nhs.uk> List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html <http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html> List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
________________________________
This message contains information from Belfast Health And Social Care Trust which may be privileged and confidential.
If you believe you are not the intended recipient any disclosure, distribution or use of the contents is prohibited.
If you have received this message in error please notify the sender immediately.
This email has been scanned for the presence of computer viruses.
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|