A 42-year-old woman with systemic lupus erythematosus presents with recurrent bilateral lower extremity thromboses. Vital signs: BP 138/88 mmHg, HR 92/min, RR 18/min, temp 37.2°C, SpO2 98% on room air. Laboratory studies reveal fasting triglycerides 310 mg/dL, HDL 22 mg/dL, lipoprotein(a) 85 nmol/L, and lupus anticoagulant positivity. Platelet count remains normal. She takes hydroxychloroquine and prednisone. Which mechanism best explains the link between SLE and these lipoprotein abnormalities?
- A)SLE-induced immune complex deposition in hepatocytes prevents cholesterol synthesis
- B)Lupus anticoagulant directly impairs lipoprotein lipase activity and apoA-I synthesis
- C)Anti-phospholipid antibodies prevent LDL particle formation in the endoplasmic reticulum
- D)Hydroxychloroquine therapy blocks HMG-CoA reductase, reducing lipoprotein synthesis
- E)Chronic inflammation and oxidative stress increase lipoprotein(a) synthesis and impair HDL-mediated reverse cholesterol transportGABARITO
Explicação
SLE is characterized by chronic systemic inflammation, immune activation, and oxidative stress. These conditions upregulate hepatic synthesis of acute phase proteins (including lipoprotein(a)), impair HDL-mediated reverse cholesterol transport, and promote oxi... Ver explicação completa e trilha adaptativa →