A 56-year-old woman with primary biliary cholangitis presents with progressive jaundice and pruritus. Vital signs: BP 128/82, HR 88, RR 16, Temp 37°C, SpO2 98%. Laboratory studies reveal elevated total cholesterol (320 mg/dL), normal LDL-C, elevated unesterified cholesterol, and lipoprotein-X (Lp-X) on serum electrophoresis. Alkaline phosphatase is markedly elevated at 420 U/L. Triglycerides are normal. She denies taking statins. Which of the following best explains the presence of Lp-X in her serum?
- A)Impaired hepatic synthesis of apolipoprotein B-100
- B)Deficiency of lipoprotein lipase leading to accumulation of chylomicron remnants
- C)Overproduction of HDL particles in response to liver inflammation
- D)Increased intestinal synthesis of apolipoprotein B-48
- E)Biliary obstruction prevents normal hepatic excretion of cholesterol and formation of bile acidsGABARITO
Explicação
Lipoprotein-X (Lp-X) is an abnormal lipoprotein containing unesterified cholesterol and phospholipids without apoB, appearing in cholestasis and severe hepatic disease. It forms when bile obstruction prevents normal conversion of cholesterol to bile acids and ... Ver explicação completa e trilha adaptativa →