Clinical evaluation of three types of plasmapheresis in a patient with type IIa familial hypercholesterolemia

Long-term plasmapheresis (PP) therapy was studied in a 56-year-old patient with homozygous type IIa familial hypercholesterolemia also suffering from severe coronary heart disease. Three different PP techniques, plasma exchange (PE), double-membrane-filtration plasmapheresis (DFP), and the recently developed low-density lipoprotein adsorbent column (adsorption plasmapheresis, adsorption PP), were used in an attempt to develop better means of managing the disease. All three techniques showed similar elimination efficiency with respect to plasma total cholesterol level. Adsorption PP with minimal supplemental plasma protein managed the circulatory status of the patient better than DFP during extracorporeal treatment. In the course of PP therapy xanthoma tuberosum markedly regressed, and the cardiac status of the patient was clearly improved.