A Case of Xanthomatosis and Hyperlipoproteinemia Type V Propably Induced by Overdosage of Insulin

Abstract

A woman, aged 46 years, with a hyperlipoproteinemia phenotype V, an unusual type of xanthomatosis, as well as lipemia retinalis, diabetes mellitus, and nephropathia, is discussed. The withdrawal of 64 IU insulin and the institution of a hypocaloric diabetes diet resulted in the disappearance of the skin lesions and a regression of the eye lesion. During this treatment the total lipid-level became almost normal (6,965 mg% before treatment and 947 mg% after 10 weeks). The chylomicrons disappeared but the VLDL content remained relatively and absolutely elevated, as in type IV hyperlipoproteinemia.

Eruptive Xanthoma in a Patient with Type V Hyperlipoproteinemia

“…This rapid change in the appearance of the fundus may, however, also explain 'overlooked' retinal lipemia in those cases in which there has been no repeated ocular examination to provide evidence of the transient ophthalmological signs of this variable metabolic disease. It is of note that a somewhat similar case of xanthomatosis in hyperlipopro teinemia type V with diabetes and lipemia retinalis has been described recently by Vermeer and Polano [10].…”