Primäre Hyperlipoproteinämie Typ I im Neugeborenenalter1

Newborn infants with inborn errors of lipid metabolism are relatively rare. There are only a few reports of hyperlipoproteinemia in infancy. In a six-day-old "healthy" newborn infant with a weight of 2960 gm a milky blood serum was found. Diagnosis of primary hyperlipoproteinemia type I was established by exclusion of other diseases and by analysis of blood lipids. Lack of lipoprotein lipase activity in postheparin plasma confirmed the diagnosis. The parents of the patient were normolipemic but showed reduced lipoprotein lipase activity. Thus, they were recognized as heterozygotes. A low fat (6-19 gm fat/d, 2-3 gm fat/kg bodyweight/d) diet with a high proportion of medium-chain triglycerides (78% MCT) lowered the initially extremely high serum triglyceride level (3674 mg/dl) significantly (214-711 mg/dl). Until the age of 7 months body weight and length followed the 10. percentile, head circumference followed the 50. percentile. Unexpectedly the patient died of pulmonary infection at the age of 8 months.