Severe Hypercholesterolemia: A Unique Presentation of Non-Hodgkin’s Lymphoma in a Patient with Neurofibromatosis Type 1

Abstract

We report a case of non-Hodgkin's lymphoma (NHL) with an unusual initial manifestation as severe hypercholesterolemia and obstructive jaundice in a patient with neurofibromatosis type 1 (NF 1). NHL should be considered in the evaluation of obstructive jaundice alone or in combination with severe hypercholesterolemia. Relief of biliary obstruction led to the resolution of hypercholesterolemia in our 59-year-old male patient, followed by doxorubicin-based chemotherapy for the underlying lymphoma. NF 1 is a genetic condition that results from a defect in a tumor-suppressor gene and it is likely that this led to the development of NHL in our patient. It is important that clinicians are familiar with the gastrointestinal manifestations of NF 1, especially its association with intra-abdominal malignancies, when treating patients with a personal or family history. To the best of our knowledge, this is the first case of NHL presenting initially as severe hypercholesterolemia and it is also one of the few instances where NHL has been reported in association with NF 1.

Association of serum calprotectin (S100A8/A9) concentrations and idiopathic hyperlipidemia in Miniature Schnauzers

“…A possible explanation for this discrepancy could be a difference in the populations of dogs in both studies. However, although every effort was made to exclude dogs with a condition known to cause secondary hyperlipidemia, the possibility of missing an occult or rare cause of secondary hyperlipidemia cannot be entirely excluded.…”

Pseudohyponatremia: Mechanism, Diagnosis, Clinical Associations and Management

“…Two methods, field mass spectrometry and enzymatic determination, are worth exploring: field mass spectrometry is a promising recent technology for measuring electrolyte concentrations in biological fluids [ 164 , 165 ]; its measurement of the sodium concentration based on specific enzyme (β-galactosidase) activation by sodium ions has been applied in certain clinical conditions, e.g., isolation laboratories for emerging infectious diseases [ 26 , 166 , 167 ]. The Supplementary Material Section S1 provides further information about conditions causing hyperlipidemia [ 153 , 154 , 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 , 180 , 181 , 182 , 183 , 184 , 185 , 186 , 187 , 188 , 189 , 190 , 191 , 192 , 193 , 194 , 195 , 196 , 197 ].…”

“…The following supporting information can be downloaded at: , Section S1-Clinical conditions causing increased serum solid content [ 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 , 180 , 181 , 182 , 183 , 184 , 185 , 186 , 187 , 188 , 189 , 190 , 191 , 192 , 193 , 194 , 195 , 196 , 197 ].…”

Hyponatremia in Patients with Hematologic Diseases

“…A case of type III hyperlipoproteinemia with xanthomas has been reported in a patient with multiple myeloma (MM) [ 21 ]. Furthermore, severe secondary hypercholesterolemia due to cholestasis in a patient who had obstructive jaundice as the initial presentation of non-Hodgkin’s lymphoma (NHL) has been reported [ 22 ]. L-asparaginase, an essential agent in treating ALL, induces hypertriglyceridemia, which may be further intensified by the co-administration of steroids [ 23 , 24 ].…”